Individual provider Active NPI

Marlene Mary Jose, LPN

  • Licensed Practical Nurse
  • Tucson, AZ
National Provider Identifier
1215136205
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LP108254 Issued in AZ
Practice address
7900 S J Stock Rd
Tucson, AZ 85746-7012
Phone
(520) 295-2503
Fax
(520) 295-2676
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LP108254AZMDLicensed Practical Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LP108254 AZ Primary

Addresses

NPPES NPI Registry

Primary practice location

7900 S J Stock Rd
Tucson, AZ 85746-7012

Mailing address

7900 S J Stock Rd
Tucson, AZ 85746-7012
Phone (520) 295-2503

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 11, 2007.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1215136205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 S J STOCK RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857467012",
            "telephone_number": "520-295-2503",
            "fax_number": "520-295-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 S J STOCK RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857467012",
            "telephone_number": "520-295-2503",
            "fax_number": "520-295-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSE",
        "first_name": "MARLENE",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP108254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.