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Individual

SANDRA NICOLE DINWIDDIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
A-GNP

Contact information

Practice address
20823 N CAVE CREEK RD STE 103, PHOENIX, AZ 85024-4469
(623) 439-5585
(623) 439-7775
Mailing address
3120 W CAREFREE HWY STE 1, PHOENIX, AZ 85086-3202
(623) 439-5585
(623) 439-7775

Taxonomy

Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
AP10488
AZ
363L00000X
Nurse Practitioner
AP10488
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP10488
AZ
363LG0600X
Gerontology Nurse Practitioner
AP10488
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Z211463
AZ
Enumeration date
11/19/2016
Last updated
09/30/2020
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