Healthcare Provider Details

I. General information

NPI: 1598811598
Provider Name (Legal Business Name): RENEE DULL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E ELLIOT RD
GILBERT AZ
85234-6924
US

IV. Provider business mailing address

1101 E ELLIOT RD
GILBERT AZ
85234-6924
US

V. Phone/Fax

Practice location:
  • Phone: 480-497-0177
  • Fax: 480-497-4029
Mailing address:
  • Phone: 480-497-0177
  • Fax: 480-497-4029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN120316
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberSN0700
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: