Provider Demographics
NPI:1124203682
Name:ERRAZO-SEARLES, MARILOU (AD RN)
Entity Type:Individual
Prefix:MRS
First Name:MARILOU
Middle Name:
Last Name:ERRAZO-SEARLES
Suffix:
Gender:F
Credentials:AD RN
Other - Prefix:MISS
Other - First Name:MARILOU
Other - Middle Name:
Other - Last Name:ERRAZO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:11109 E TANQUE VERDE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749
Mailing Address - Country:US
Mailing Address - Phone:520-749-3772
Mailing Address - Fax:520-749-3772
Practice Address - Street 1:11109 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749
Practice Address - Country:US
Practice Address - Phone:520-749-3772
Practice Address - Fax:520-749-3772
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN105263163W00000X, 163WC3500X
AZALH-6273311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)