Provider Demographics
NPI:1497202584
Name:DINGLE, DANYELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:DANYELLE
Middle Name:
Last Name:DINGLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9852 W HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-8387
Mailing Address - Country:US
Mailing Address - Phone:480-889-0508
Mailing Address - Fax:
Practice Address - Street 1:14674 W MOUNTAIN VIEW BLVD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2706
Practice Address - Country:US
Practice Address - Phone:623-544-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6534363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical