Healthcare Provider Details

I. General information

NPI: 1023158607
Provider Name (Legal Business Name): MARSHA MARIE DOBBERTIN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2013 N 36TH ST
PHOENIX AZ
85008-3026
US

IV. Provider business mailing address

15017 N 60TH ST
SCOTTSDALE AZ
85254-2467
US

V. Phone/Fax

Practice location:
  • Phone: 602-381-6107
  • Fax:
Mailing address:
  • Phone: 480-945-3011
  • Fax: 480-874-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN024969
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: