Provider Demographics
NPI:1285372474
Name:AZBILL, DAWN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:AZBILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 E EDWARD LN
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-9724
Mailing Address - Country:US
Mailing Address - Phone:520-971-9615
Mailing Address - Fax:
Practice Address - Street 1:335 S OCOTILLO AVE
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602-6406
Practice Address - Country:US
Practice Address - Phone:520-586-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN165280163WC0200X
AZ277427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F04220556OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
AZRN165280OtherARIZONA BOARD OF NURSING