Marguerite Elizabeth Havlis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110937 Issued in AZ

Practice address

1400 N Wilmot Rd
Tucson, AZ 85712-4498

Phone

(520) 324-5090

Fax

(520) 324-5236

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• TMC Medical Network

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1750832283
  Medicare reassignment NPD
• Tucson Medical Center

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1174512792
  Medicare reassignment NPD
• Tucson Medical Center

  dba Tucson Medical Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Tucson, AZ
  • NPI 1972876563
  NPD
• Tucson Medical Center

  dba Palo Verde Hospital

  • Psychiatric Hospital Unit
  • Tucson, AZ
  • NPI 1881683126
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1568497055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31235",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857511235",
            "telephone_number": "520-324-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857124498",
            "telephone_number": "520-324-5090",
            "fax_number": "520-324-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLIS",
        "first_name": "MARGUERITE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "110937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "582363",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haven Sendero de Sonora
• Haven Sendero de Sonora, Inc. (Sendero de Sonora)
• Haven Springs at Tanque Verde LLC
• Haven Springs at Tucson, LLC (Haven Springs at Tucson)
• Kathleen Joyce Havens, RN, BSN
• Jacob Hawbaker, LAMFT
• Robert Francis Hawke, DDS
• Hawkeye Surgical Services, LLC
• Brandon Hawkins, LCSW
• Cherrelle Hawkins, RN, CHES(R), CPHT

• Family Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.