Provider Demographics
NPI:1578918934
Name:SINCLAIR, DYAN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DYAN
Middle Name:
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:DYAN
Other - Middle Name:
Other - Last Name:FAUSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3750 HWAY 95
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-8218
Mailing Address - Country:US
Mailing Address - Phone:928-444-1444
Mailing Address - Fax:
Practice Address - Street 1:3750 HWAY 95
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8218
Practice Address - Country:US
Practice Address - Phone:928-444-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8580363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily