Provider Demographics
NPI:1225579808
Name:DEMERS, DENNIS GEORGE (RN)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:GEORGE
Last Name:DEMERS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-2449
Mailing Address - Country:US
Mailing Address - Phone:520-458-3935
Mailing Address - Fax:520-586-6125
Practice Address - Street 1:4755 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2449
Practice Address - Country:US
Practice Address - Phone:520-458-3935
Practice Address - Fax:520-586-6125
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN163806163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult