MR. DUSTIN BRANT IVANIC (NPI# 1497294748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497294748 |
| Entity Type | Individual |
| Full Name | MR. DUSTIN BRANT IVANIC |
| Credential | FNP-C |
| Practice Address |
3255 S Rural Rd Tempe AZ 85282-3853 |
| Mailing Address |
2620 Elm Hill Pike Nashville TN 37214-3108 |
| Practice Telephone | 4803045467 |
| Mailing Telephone | 6154254200 |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP9722 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3255 S RURAL RD |
| City | TEMPE |
| State | AZ |
| Zip Code | 85282-3853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184628521 | Ann M Tracy | Nurse Practitioner | 3255 S Rural Rd, Tempe, AZ 85282 | 2005-06-13 |
| 1043836273 | Sri Mangala Gouri Duriseti | Pharmacist | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2020-06-23 |
| 1972015469 | Anitha Sreeni | Nurse Practitioner | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2017-10-25 |
| 1639623952 | Kimberly Pham | Pharmacist | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2016-08-04 |
| 1912312372 | Lynn G Fredes | Registered Nurse | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2014-06-24 |
| 1760807903 | Karen Blanco | Nurse Practitioner | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2014-02-25 |
| 1376887182 | The Little Clinic of Arizona LLC | Physician Assistant | 3255 S Rural Rd, Tempe, AZ 85282 | 2012-11-16 |
| 1982951455 | Gloria B Sun | Pharmacist | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2012-08-14 |
| 1194051953 | Jaime Lawless | Pharmacist | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2009-10-28 |
| 1306084447 | Camera Ann Lumumba | Nurse Practitioner | 3255 S Rural Rd, Tempe, AZ 85282-3853 | 2009-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346893575 | Cactus Canyon Dental | Dentist | 2043 E Southern Ave, Ste. C, Tempe, AZ 85282 | 2019-07-17 |
| 1023679644 | Donna Cooks | Registered Nurse | 233 E. Sourthern Ave #27702, Tempe, AZ 85282 | 2019-06-25 |
| 1841854932 | Lynn Stafford | Registered Nurse | 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-04-24 |
| 1598227340 | Jane Ramenofsky Ramenofsky Stewart | Registered Nurse | 4041 So. Mcclintock Suite 302, Tempe, AZ 85282 | 2019-04-02 |
| 1588129902 | Mary K Wheeler Mcfarland | Registered Nurse | Adobe Care and Wellness LLC, Address Is 4041 S. Mcclintock, Ste 302, Tempe, AZ 85282 | 2019-02-11 |
| 1669949780 | Crestview Pharmacy Services LLC | Pharmacy | 3225 South Hardy Dr., Ste 100, Tempe, AZ 85282 | 2018-10-26 |
| 1275018715 | Berlin Wright | Naturopath | 2164 E. Broadway Rd., Tempe, AZ 85282 | 2018-10-01 |
| 1043701543 | Lakeshore Interventional Treatment Center LLC | Surgery | 4765 S Lakeshore Dr, Tempe, AZ 85282 | 2018-05-21 |
| 1427553940 | The Bridge Counseling, Consulting and Mediation LLC | Counselor | 4625 S. Lakeshore Dr., 302, Tempe, AZ 85282 | 2018-03-27 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| Find all providers in zip 85282 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861091175 | Guiding Light Holistic Healthcare | Nurse Practitioner | 9758 S La Rosa Dr, Tempe, AZ 85284-5004 | 2020-10-19 |
| 1689271686 | Renew Health Surgery Center LLC | Nurse Practitioner | 426 E Southern Ave Ste 102, Tempe, AZ 85282-5215 | 2020-10-03 |
| 1598377715 | Sarah Briggs | Nurse Practitioner | 527 W Malibu Dr, Tempe, AZ 85282-4815 | 2020-08-19 |
| 1073124525 | Cinthia Guadalupe Arredondo Paramo | Nurse Practitioner | 1840 W. Broadway Rd., Tempe, AZ 85281 | 2020-08-10 |
| 1083265011 | Marlaine Baldelli | Nurse Practitioner | 9010 S Priest Dr Apt 2045, Tempe, AZ 85284-1081 | 2019-09-20 |
| 1619534971 | Takako Yamada | Nurse Practitioner | 7650 S Mcclintock Dr Ste 103-340, Tempe, AZ 85284-1672 | 2019-05-22 |
| 1508370784 | Kayla D'lisa Rene Worley | Nurse Practitioner | 931 E Elliot Rd Ste 107, Tempe, AZ 85284-1583 | 2017-11-26 |
| 1417469669 | Tiba Care Pllc | Nurse Practitioner | 315 W Elliot Rd Ste 107-167, Tempe, AZ 85284-1328 | 2017-10-27 |
| 1962953703 | Rachel Marissa Friedman | Nurse Practitioner | 1805 N Scottsdale Rd Ste 120, Tempe, AZ 85281-1556 | 2016-10-17 |
| 1225496060 | Jennifer Ann Muhammad | Nurse Practitioner | 512 E Southern Ave Ste B, Tempe, AZ 85282-5209 | 2016-02-08 |
| Find all providers in TEMPE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.