Provider Demographics
NPI:1326419847
Name:DENNIS-TODD, ANTIONETTE NMN
Entity Type:Individual
Prefix:
First Name:ANTIONETTE
Middle Name:NMN
Last Name:DENNIS-TODD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANTIONETTE
Other - Middle Name:NMN
Other - Last Name:DENNIS- TODD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:18789 S AVENIDA RIO VELOZ
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8172
Mailing Address - Country:US
Mailing Address - Phone:520-407-6659
Mailing Address - Fax:
Practice Address - Street 1:1260 S CAMPBELL AVE
Practice Address - Street 2:UCHC CONTINENTAL FAMILY MEDICAL CENTER
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-0503
Practice Address - Country:US
Practice Address - Phone:520-407-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8138363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner