Provider Demographics
NPI:1578663126
Name:WERTMAN, FRANCES L (CNM)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:L
Last Name:WERTMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2595 N WYATT DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6104
Mailing Address - Country:US
Mailing Address - Phone:520-795-9912
Mailing Address - Fax:520-795-9934
Practice Address - Street 1:2595 N WYATT DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6104
Practice Address - Country:US
Practice Address - Phone:520-795-9912
Practice Address - Fax:520-795-9934
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN127300367A00000X
AZAP1911367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS864935Medicaid
AS864935Medicaid
AZ80290Medicare ID - Type Unspecified01-7 TIN