Provider Demographics
NPI:1669475125
Name:DAHN, JANEEN MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JANEEN
Middle Name:MARIE
Last Name:DAHN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5422 W GERONIMO ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4581
Mailing Address - Country:US
Mailing Address - Phone:480-320-8669
Mailing Address - Fax:
Practice Address - Street 1:5422 W GERONIMO ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4581
Practice Address - Country:US
Practice Address - Phone:480-320-8669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ77377Medicare ID - Type UnspecifiedINDIVIDUAL
AZ77375Medicare ID - Type UnspecifiedGROUP
AZP00989Medicare UPIN