Provider Demographics
NPI:1508417312
Name:TOLMACHOFF, ADDY (RN)
Entity Type:Individual
Prefix:MRS
First Name:ADDY
Middle Name:
Last Name:TOLMACHOFF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 S 339TH AVE
Mailing Address - Street 2:
Mailing Address - City:TONOPAH
Mailing Address - State:AZ
Mailing Address - Zip Code:85354-7019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:751 N 215TH AVE
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-6525
Practice Address - Country:US
Practice Address - Phone:623-238-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN207420163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool