Healthcare Provider Details

I. General information

NPI: 1285905315
Provider Name (Legal Business Name): DANA M GARNER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2012
Last Update Date: 08/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18700 N 64TH DR SUITE 208
GLENDALE AZ
85308-7109
US

IV. Provider business mailing address

18700 N 64TH DR SUITE 208
GLENDALE AZ
85308-7109
US

V. Phone/Fax

Practice location:
  • Phone: 623-258-3255
  • Fax: 623-478-2215
Mailing address:
  • Phone: 623-258-3255
  • Fax: 623-478-2215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberTAP4353
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: