Provider Demographics
NPI:1285905315
Name:GARNER, DANA M (NP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:GARNER
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Gender:F
Credentials:NP
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Mailing Address - Street 1:18700 N 64TH DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7109
Mailing Address - Country:US
Mailing Address - Phone:623-258-3255
Mailing Address - Fax:623-478-2215
Practice Address - Street 1:18700 N 64TH DR
Practice Address - Street 2:SUITE 208
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7109
Practice Address - Country:US
Practice Address - Phone:623-258-3255
Practice Address - Fax:623-478-2215
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2016-08-26
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Provider Licenses
StateLicense IDTaxonomies
AZTAP4353363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ684302Medicaid