Provider Demographics
NPI:1821650201
Name:DAGNY, REBEKAH ELLEN (PEDIATRIC NURSE PRAC)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:ELLEN
Last Name:DAGNY
Suffix:
Gender:F
Credentials:PEDIATRIC NURSE PRAC
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:ELLEN
Other - Last Name:CHARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PEDIATRIC NURSE PRAC
Mailing Address - Street 1:3033 N CENTRAL AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2808
Mailing Address - Country:US
Mailing Address - Phone:623-583-3001
Mailing Address - Fax:
Practice Address - Street 1:15351 W BELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4580
Practice Address - Country:US
Practice Address - Phone:480-964-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ227489363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics