Healthcare Provider Details

I. General information

NPI: 1083693865
Provider Name (Legal Business Name): BARBARA DUPAUL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 E WILLIAMS FIELD RD VA MEDICAL CENTER
MESA AZ
85212-6033
US

IV. Provider business mailing address

6950 E WILLIAMS FIELD RD VA MEDICAL CENTER
MESA AZ
85212-6033
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN 092795
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: