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NPI 1689191397

NPI 1689191397 : DANIEL FIMBRES RN : AVONDALE, AZ

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General NPI Number Information
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    NPI Number           |    1689191397
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    Entity Type          |    Individual 
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    Provider Name        |    DANIEL FIMBRES RN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/23/2017
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    Last Update Date     |    11/21/2018
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Provider Practice Location Address
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    Address Line         |    950 E VAN BUREN ST 
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    City                 |    AVONDALE
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    State                |    AZ
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    Zip                  |    85323-1506
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    Country              |    US
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    Telephone            |    623-344-6800
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    Fax                  |    623-344-6801
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Provider Business Mailing Address
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    Address Line         |    950 E VAN BUREN ST 
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    City                 |    AVONDALE
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    State                |    AZ
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    Zip                  |    85323-1506
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    Country              |    US
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    Telephone            |    623-344-6800
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    Fax                  |    623-344-6801
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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        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    AP11221
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    License Number State |    AZ
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