Provider Demographics
NPI:1821254996
Name:DIAS, DOLORES L (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:L
Last Name:DIAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14219 N HAWTHORN CT APT A
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2127
Mailing Address - Country:US
Mailing Address - Phone:480-837-0653
Mailing Address - Fax:480-837-0653
Practice Address - Street 1:14219 N HAWTHORN CT APT A
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-2127
Practice Address - Country:US
Practice Address - Phone:480-837-0653
Practice Address - Fax:480-837-0653
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP 3026363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily