Provider Demographics
NPI:1346677697
Name:DUMLAO, RITA-LYNN ANDERSON (PA-C, ATC)
Entity Type:Individual
Prefix:MRS
First Name:RITA-LYNN
Middle Name:ANDERSON
Last Name:DUMLAO
Suffix:
Gender:F
Credentials:PA-C, ATC
Other - Prefix:MS
Other - First Name:RITA-LYNN
Other - Middle Name:REYES
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, ATC
Mailing Address - Street 1:PSC 704 BOX 2802
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-0009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 704 BOX 2802
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96338-0009
Practice Address - Country:US
Practice Address - Phone:520-505-7581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical