Provider Demographics
NPI:1326395344
Name:BODEMULLER, DOROTHY (RN)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:
Last Name:BODEMULLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18034 N 41ST ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-1797
Mailing Address - Country:US
Mailing Address - Phone:602-867-2071
Mailing Address - Fax:
Practice Address - Street 1:18034 N 41ST ST
Practice Address - Street 2:APT. 1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-1797
Practice Address - Country:US
Practice Address - Phone:602-867-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN052664163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health