Provider Demographics
NPI:1528941283
Name:TATU, DENNIS (FNP-S)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:TATU
Suffix:
Gender:M
Credentials:FNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18023 W RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-7568
Mailing Address - Country:US
Mailing Address - Phone:949-394-6904
Mailing Address - Fax:
Practice Address - Street 1:18023 W RAYMOND ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-7568
Practice Address - Country:US
Practice Address - Phone:949-394-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ253222163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency