Provider Demographics
NPI:1598279275
Name:HSU, ESTHER FENFANG
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:FENFANG
Last Name:HSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FENFANG
Other - Middle Name:
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4302 E BELLEVUE ST APT D
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4638
Mailing Address - Country:US
Mailing Address - Phone:714-858-5018
Mailing Address - Fax:
Practice Address - Street 1:545 N CAMINO SECO
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3067
Practice Address - Country:US
Practice Address - Phone:520-731-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP053703164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse