Healthcare Provider Details

I. General information

NPI: 1285372474
Provider Name (Legal Business Name): DAWN AZBILL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 S OCOTILLO AVE
BENSON AZ
85602-6406
US

IV. Provider business mailing address

2942 E EDWARD LN
VAIL AZ
85641-9724
US

V. Phone/Fax

Practice location:
  • Phone: 520-586-4040
  • Fax:
Mailing address:
  • Phone: 520-971-9615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN165280
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277427
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: