Provider Demographics
NPI:1740838101
Name:BORING, PAUL (RN)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BORING
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 N NAVAJO ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2040
Mailing Address - Country:US
Mailing Address - Phone:602-451-6154
Mailing Address - Fax:
Practice Address - Street 1:6552 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710
Practice Address - Country:US
Practice Address - Phone:623-335-5575
Practice Address - Fax:623-227-2466
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ315336363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health