Individual
MS. SANDRA DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Contact information
Practice address
HIGHWAY 191 AND PH DRIVE, CHINLE, AZ 86503
(928) 674-7420
(928) 674-7461
Mailing address
PO BOX PH, CCHCF, CHINLE, AZ 86503
(928) 674-7420
(928) 674-7461
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R18238
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3102957
—
NM
Enumeration date
06/30/2006
Last updated
03/15/2011
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