Provider Demographics
NPI:1841416146
Name:TULIO, ALICE P (LPN)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:P
Last Name:TULIO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3878 W MARS DR
Mailing Address - Street 2:3878 MARS DR
Mailing Address - City:SOMERTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85350-7255
Mailing Address - Country:US
Mailing Address - Phone:928-627-3227
Mailing Address - Fax:
Practice Address - Street 1:3878 W MARS DR
Practice Address - Street 2:3878 MARS DR
Practice Address - City:SOMERTON
Practice Address - State:AZ
Practice Address - Zip Code:85350-7255
Practice Address - Country:US
Practice Address - Phone:928-627-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP023635164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse