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General NPI Number Information
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NPI Number | 1588108633
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Entity Type | Organization
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Legal Business Name | DR. NLGD, LLC
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 2487 S GILBERT RD STE 106-502
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City | GILBERT
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State | AZ
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Zip | 85295-2832
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Country | US
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Telephone | 480-669-6452
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Fax | 888-977-3601
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Provider Business Mailing Address
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Address Line | 2487 S GILBERT RD STE 106-502
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City | GILBERT
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State | AZ
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Zip | 85295-2832
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Country | US
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Telephone | 480-669-6452
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Fax | 888-977-3601
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Authorized Official
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Title or Position | DNP
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Name | DR. NANCY LEE GAINES-DILLARD
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Credential | DNP-APRN-BC
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Telephone | 480-669-6452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP8274
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License Number State | AZ
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