Provider Demographics
NPI:1760044564
Name:MILBRANDT, MARCY RAE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:RAE
Last Name:MILBRANDT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MARCY
Other - Middle Name:RAE
Other - Last Name:LEARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5255 W BOBWHITE WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-9371
Mailing Address - Country:US
Mailing Address - Phone:520-612-6414
Mailing Address - Fax:
Practice Address - Street 1:2800 E AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6204
Practice Address - Country:US
Practice Address - Phone:520-874-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN168405207P00000X
AZ249788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine