=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972666295
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONNA MARIE DUNDON FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10900 N SCOTTSDALE RD # 303
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85254-5216
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-860-2455
-----------------------------------------------------
Fax | 480-767-5574
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8842 E PALM RIDGE DR
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-7093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-361-1018
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN075816
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------