Individual provider Active NPI

Emmalyn Pothen, RN

  • Registered Nurse
  • Tucson, AZ
National Provider Identifier
1912781980
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
294764 Issued in AZ
Practice address
The University of Arizona
Tucson, AZ 85721-0001
Phone
(651) 207-3640
NPI assigned
Aug 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2482587 MN
Registered Nurse 163W00000X 294764 AZ Primary

Addresses

Primary practice location

The University of Arizona
Tucson, AZ 85721-0001

Mailing address

6901 E Chauncey LN Apt 2096
Phoenix, AZ 85054-5124

Other names 1

  • Emmalyn Boeser Former name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
294764AZMDRegistered Nurse
2482587MNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1912781980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 E CHAUNCEY LN APT 2096",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850545124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE UNIVERSITY OF ARIZONA",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857210001",
            "telephone_number": "651-207-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTHEN",
        "first_name": "EMMALYN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2482587",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "294764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMALYN",
            "last_name": "BOESER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 22, 2023; 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.