Provider Demographics
NPI:1003159070
Name:GALVAN, DINAPOLES
Entity type:Individual
Prefix:
First Name:DINAPOLES
Middle Name:
Last Name:GALVAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 N SCOTTSDALE RD STE 240
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3594
Mailing Address - Country:US
Mailing Address - Phone:480-900-7256
Mailing Address - Fax:480-900-7256
Practice Address - Street 1:743 MILLER VALLEY RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-1813
Practice Address - Country:US
Practice Address - Phone:928-777-9600
Practice Address - Fax:855-449-5560
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9548024163W00000X
IL209025036163W00000X, 363LP0808X
AZ312571363LP0808X
FL11018626363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse