Provider Demographics
NPI:1427034479
Name:VONRUEDEN, ARACELIS M (NP)
Entity Type:Individual
Prefix:MRS
First Name:ARACELIS
Middle Name:M
Last Name:VONRUEDEN
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 1:523 N TUCSON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4411
Mailing Address - Country:US
Mailing Address - Phone:520-323-5577
Mailing Address - Fax:520-323-5547
Practice Address - Street 1:523 N TUCSON BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4411
Practice Address - Country:US
Practice Address - Phone:520-323-5577
Practice Address - Fax:520-323-5547
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN052028363LX0001X, 363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ195132Medicaid
AZ195132Medicaid
AZ100406Medicare ID - Type Unspecified