Provider Demographics
NPI:1932505617
Name:GUEST NELSON, DORCAS
Entity Type:Individual
Prefix:
First Name:DORCAS
Middle Name:
Last Name:GUEST NELSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DORCAS
Other - Middle Name:
Other - Last Name:GUEST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:4823 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3471
Mailing Address - Country:US
Mailing Address - Phone:602-550-3445
Mailing Address - Fax:
Practice Address - Street 1:3811 N 44TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5420
Practice Address - Country:US
Practice Address - Phone:480-484-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN186958163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse