Provider Demographics
NPI:1982142659
Name:AMIN, DIMPLE (FNP-C)
Entity type:Individual
Prefix:
First Name:DIMPLE
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 W ELLIOT RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5186
Mailing Address - Country:US
Mailing Address - Phone:480-496-2699
Mailing Address - Fax:877-422-3184
Practice Address - Street 1:1466 W ELLIOT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5186
Practice Address - Country:US
Practice Address - Phone:480-496-2699
Practice Address - Fax:877-422-3184
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9849363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily