Provider Demographics
NPI:1558240366
Name:DYER, DANIELLE (RN, APRN, PMHNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DYER
Suffix:
Gender:X
Credentials:RN, APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4764 E SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-4535
Mailing Address - Country:US
Mailing Address - Phone:575-665-8907
Mailing Address - Fax:
Practice Address - Street 1:4764 E SUNRISE DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-4535
Practice Address - Country:US
Practice Address - Phone:575-665-8907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ287576363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse