Provider Demographics
NPI:1912049271
Name:DYE, NANCY KATHERINE (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:KATHERINE
Last Name:DYE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:WEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8172 N 22ND DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7890
Mailing Address - Country:US
Mailing Address - Phone:480-383-9025
Mailing Address - Fax:
Practice Address - Street 1:8172 N 22ND DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7890
Practice Address - Country:US
Practice Address - Phone:480-383-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2580363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ146739OtherMEDICARE PTAN
AZ187132Medicaid
AZ113625Medicare PIN
AZ187132Medicaid
AZQ76261Medicare UPIN