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General NPI Number Information
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NPI Number | 1164277885
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Entity Type | Individual
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Provider Name | DENNIS BLUTH PMNHP
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Gender | Male
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Dates
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Enumeration Date | 04/17/2024
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 560 W BROWN RD
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City | MESA
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State | AZ
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Zip | 85201-3221
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Country | US
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Telephone | 480-908-9993
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Fax |
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Provider Business Mailing Address
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Address Line | 652 W SILVER CREEK RD
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City | GILBERT
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State | AZ
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Zip | 85233-5856
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Country | US
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Telephone | 480-861-0906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 227711
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 227711
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License Number State | AZ
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