Provider Demographics
NPI:1770194243
Name:DACANAY, ALEJANDRO A (FNP)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:A
Last Name:DACANAY
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:A
Other - Last Name:DACANAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 6423
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6423
Mailing Address - Country:US
Mailing Address - Phone:480-855-2224
Mailing Address - Fax:
Practice Address - Street 1:1432 S DOBSON RD STE 106
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4769
Practice Address - Country:US
Practice Address - Phone:480-969-3637
Practice Address - Fax:480-969-6568
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAPRN221834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily