Provider Demographics
NPI:1508570797
Name:MORET, MARY E (FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:MORET
Suffix:
Gender:
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9462 N INDIAN FIG WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8274
Mailing Address - Country:US
Mailing Address - Phone:480-684-0668
Mailing Address - Fax:520-549-1800
Practice Address - Street 1:2325 E FRY BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2713
Practice Address - Country:US
Practice Address - Phone:520-549-1508
Practice Address - Fax:520-549-1800
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ285829363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily