Defore, Martha Anne
Defore, Martha Anne is an individual health care provider with primary practice located at 1601 W Saint Marys Rd , Tucson AZ 85745-2682. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medical Services is her primary health care specialty. Defore, Martha Anne can be contacted via phone (520) 872-4901.Contact Information
Primary practice address
1601 W Saint Marys Rd
Tucson AZ 85745-2682
Phone: (520) 872-4901
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 18506 | California |
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 3790 | Arizona |
Profile Details
| NPI number | 1518022961 |
|---|---|
| LBN Legal business name | Defore, Martha Anne |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Apr 30th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518022961 | NPPES |
| California | Other | 18506 | STATE LICENCE |
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