Provider Demographics
NPI:1023119492
Name:DIMMITT, PAULA JEAN (MS, RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:DIMMITT
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Gender:F
Credentials:MS, RN, CPNP
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Mailing Address - Street 1:2621 MONTCLAIR LN
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1123
Mailing Address - Country:US
Mailing Address - Phone:972-743-3517
Mailing Address - Fax:214-456-2897
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:ENT CLINIC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2042
Practice Address - Fax:214-456-2897
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-08-15
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Provider Licenses
StateLicense IDTaxonomies
TX424154363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics