Healthcare Provider Details

I. General information

NPI: 1649334293
Provider Name (Legal Business Name): MARIA MARGARET DENNY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FRONSKE HEALTH CTR P.O. 6033
FLAGSTAFF AZ
86011-0001
US

IV. Provider business mailing address

793 N CANYON TERRACE DR
FLAGSTAFF AZ
86001-4804
US

V. Phone/Fax

Practice location:
  • Phone: 928-523-2131
  • Fax: 928-523-1102
Mailing address:
  • Phone: 928-774-3327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP2565
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: