Healthcare Provider Details

I. General information

NPI: 1124736467
Provider Name (Legal Business Name): DANA J ALBALATE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 E HIGHWAY 90
SIERRA VISTA AZ
85635-9111
US

IV. Provider business mailing address

2200 EL CAMINO REAL
SIERRA VISTA AZ
85635-5903
US

V. Phone/Fax

Practice location:
  • Phone: 520-263-3620
  • Fax:
Mailing address:
  • Phone: 609-923-8768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number283642
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number283642
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: