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Individual

DESIREE M DENNULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
38843 DEXTER RD, DEXTER, OR 97431-9600
(541) 937-2134
(541) 937-1370
Mailing address
1115 SE 164TH AVE DEPT 358, VANCOUVER, WA 98683-8004
(360) 729-1253
(360) 729-3185

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10000466
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/02/2020
Last updated
02/20/2023
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