Provider Demographics
NPI:1043756380
Name:BOTTAI, ERIN (NP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BOTTAI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 N WYATT DR
Mailing Address - Street 2:STE. 260
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6115
Mailing Address - Country:US
Mailing Address - Phone:520-545-0608
Mailing Address - Fax:
Practice Address - Street 1:6565 E CARONDELET DR
Practice Address - Street 2:STE. 300
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2157
Practice Address - Country:US
Practice Address - Phone:520-323-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9788363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology