Provider Demographics
NPI:1821899303
Name:DAVIS, DIONA (ACNPC-AG)
Entity type:Individual
Prefix:MS
First Name:DIONA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W FAIRVIEW ST STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4712
Mailing Address - Country:US
Mailing Address - Phone:480-800-4890
Mailing Address - Fax:
Practice Address - Street 1:2201 W FAIRVIEW ST STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-4712
Practice Address - Country:US
Practice Address - Phone:480-800-4890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ322426363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology