Healthcare Provider Details

I. General information

NPI: 1891756045
Provider Name (Legal Business Name): DOROTHY A TRIMMER F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3638 E SOUTHERN AVE STE C108
MESA AZ
85206-2564
US

IV. Provider business mailing address

3638 E SOUTHERN AVE STE C108
MESA AZ
85206-2564
US

V. Phone/Fax

Practice location:
  • Phone: 480-834-0771
  • Fax: 480-834-1136
Mailing address:
  • Phone: 480-834-0771
  • Fax: 480-834-1136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN048734
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPCERTIFICATE #397
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: