MARY GDULA FNP - NPI 1124092242 - Nurse Practitioner in Grand Canyon, AZ

Q: What is Mary Gdula's NPI number?

The NPI number for Mary Gdula is 1124092242. It was assigned to this individual provider in the NPPES registry on February 15, 2006.

Q: What is Mary Gdula's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Gdula was last updated on October 22, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mary Gdula Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY GDULA FNP (NPI 1124092242) is an individual family provider in Grand Canyon, Arizona, licensed in Arizona (AP1443) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1124092242

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMARY GDULACredential: FNP

Location Address1 CLINIC ROADGrand Canyon, AZ 86023

Mailing AddressPo Box 3630Flagstaff, AZ 86003-3630 · (928) 233-5110 · Fax (928) 774-6687

Phone(928) 213-6121

Fax(928) 213-6136

Sole ProprietorNo

Enumeration DateFebruary 15, 2006

Last NPPES UpdateOctober 22, 2013

✔ NPI 1124092242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AZ · AP1443

Also ListedRegistered NurseTaxonomy 163W00000X · License RN116942 (AZ)

1 CLINIC ROAD, Grand Canyon, AZ 86023

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Other Identifiers 1

Other764755AZ · Ahcccs

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS MARTIN PT

Physical Therapist