Provider Demographics
NPI:1689794257
Name:MATHER, DANA B (FNP-C)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:B
Last Name:MATHER
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 1:13575 W. INDIAN SCHOOL ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340
Mailing Address - Country:US
Mailing Address - Phone:623-512-4310
Mailing Address - Fax:623-512-4311
Practice Address - Street 1:13575 W. INDIAN SCHOOL ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340
Practice Address - Country:US
Practice Address - Phone:623-512-4310
Practice Address - Fax:623-512-4311
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily