Healthcare Provider Details

I. General information

NPI: 1548181506
Provider Name (Legal Business Name): DANI DUFFY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40430 N DOMIANO ST
SAN TAN VALLEY AZ
85140-7844
US

IV. Provider business mailing address

40430 N DOMIANO ST
SAN TAN VALLEY AZ
85140-7844
US

V. Phone/Fax

Practice location:
  • Phone: 928-245-9511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberAZ00014418
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: