Provider Demographics
NPI:1467260851
Name:DULIN, MARISA ANN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:ANN
Last Name:DULIN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:
Other - Last Name:GUIDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7420 E PINNACLE PEAK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3625
Mailing Address - Country:US
Mailing Address - Phone:480-202-8088
Mailing Address - Fax:
Practice Address - Street 1:7420 E PINNACLE PEAK RD STE 120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3625
Practice Address - Country:US
Practice Address - Phone:480-202-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ318618363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily