Basic Information
| Provider Information | |||||||||
| NPI: | 1649611336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIELACHA | ||||||||
| FirstName: | DAYNA | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP | ||||||||
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| OtherLastName: | SPARACINO | ||||||||
| OtherFirstName: | DAYNA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3709 N CAMPBELL AVE | ||||||||
| Address2: | STE 201 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857191563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208382122 | ||||||||
| FaxNumber: | 5208382245 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 N SWAN RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857124046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5206151023 | ||||||||
| FaxNumber: | 5203201742 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2013 | ||||||||
| LastUpdateDate: | 02/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AP5158 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | AP5158 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.