Individual
MYRA PEARL DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HWY 160 M.P. 394.3, KAYENTA, AZ 86033
(928) 697-4000
(928) 697-4301
Mailing address
PO BOX 368, KAYENTA, AZ 86033-0368
(928) 697-4000
(928) 697-4301
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA1000011700
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNA1000011700
ARIZONA STATE BOARD OF NURSING
AZ
Enumeration date
03/14/2018
Last updated
03/14/2018
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