Provider Demographics
NPI:1144210931
Name:CONTRERAS, NANCY SUE (PT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:SUE
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31630
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1630
Mailing Address - Country:US
Mailing Address - Phone:520-784-6570
Mailing Address - Fax:520-784-6574
Practice Address - Street 1:2424 N WYATT DR
Practice Address - Street 2:STE 130
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6115
Practice Address - Country:US
Practice Address - Phone:520-784-6570
Practice Address - Fax:520-784-6574
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0711225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0460450OtherBCBS
AZ781311OtherARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
Z68397Medicare ID - Type Unspecified