Provider Demographics
NPI:1336663897
Name:DUFFY, PATROCINIA GRACE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:PATROCINIA
Middle Name:GRACE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 W INA RD STE 150
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2269
Mailing Address - Country:US
Mailing Address - Phone:209-007-0205
Mailing Address - Fax:520-979-3388
Practice Address - Street 1:7725 N ORACLE RD STE 131
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85704-6987
Practice Address - Country:US
Practice Address - Phone:520-544-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-26
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily