Provider Demographics
NPI:1750917555
Name:TUCSON OUTPATIENT PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:TUCSON OUTPATIENT PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:520-429-5779
Mailing Address - Street 1:5210 N SALIDA DEL SOL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5412
Mailing Address - Country:US
Mailing Address - Phone:520-429-5779
Mailing Address - Fax:
Practice Address - Street 1:4806 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1276
Practice Address - Country:US
Practice Address - Phone:520-780-8413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)