Provider Demographics
NPI:1073613261
Name:DE STEFANO, ROBYN MARIE (RPA-C)
Entity type:Individual
Prefix:MISS
First Name:ROBYN
Middle Name:MARIE
Last Name:DE STEFANO
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 N CRAYCROFT RD BLDG 5
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2845
Mailing Address - Country:US
Mailing Address - Phone:520-296-8500
Mailing Address - Fax:
Practice Address - Street 1:2121 N CRAYCROFT RD BLDG 5
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2845
Practice Address - Country:US
Practice Address - Phone:520-296-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00476363A00000X
NY015623-1363A00000X
AZ10263363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant