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General NPI Number Information
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NPI Number | 1528941283
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Entity Type | Individual
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Provider Name | DENNIS TATU FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 18023 W RAYMOND ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-7568
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Country | US
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Telephone | 949-394-6904
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Fax |
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Provider Business Mailing Address
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Address Line | 18023 W RAYMOND ST
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City | GOODYEAR
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State | AZ
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Zip | 85338-7568
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Country | US
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Telephone | 949-394-6904
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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 | 253222
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 253222
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License Number State | AZ
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