Gagan, Mary Jo

Gagan, Mary Jo is an individual health care provider with primary practice located at 1775 E Skyline Dr Ste 101, Tucson AZ 85718-1162. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Gagan, Mary Jo can be contacted via phone (520) 615-6200.

Contact Information

Primary practice address
1775 E Skyline Dr Ste 101 Tucson AZ 85718-1162
Phone: (520) 615-6200
Fax: (520) 615-6255
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN093619 Arizona

Profile Details

NPI number 1831170364
LBN Legal business name Gagan, Mary Jo
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831170364 NPPES
Arizona MEDICAID 918021

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