Provider Demographics
NPI:1043854623
Name:ENSIGN, DEE ALLEY (PA)
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:ALLEY
Last Name:ENSIGN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:16601 N 40TH ST STE 227
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3354
Mailing Address - Country:US
Mailing Address - Phone:602-633-3721
Mailing Address - Fax:602-595-1127
Practice Address - Street 1:16601 N 40TH ST STE 227
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3354
Practice Address - Country:US
Practice Address - Phone:602-633-3721
Practice Address - Fax:602-595-1127
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ7632363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical