Individual provider · Type 1 NPI

Carolyn Dimiceli

Nurse Practitioner · Phoenix, AZ

NPI number 1356911994 Active

Practice location

4434 N 12th St
Phoenix, AZ 85014-4507

Fax (602) 242-6945

Other practice locations

  • 5940 W Union Hills Dr Ste D100, Glendale, AZ 85308-1361 · (602) 678-2500
  • 4735 E Union Hills Dr, Phoenix, AZ 85050-3362 · (602) 971-5121

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner 363LP0200X259820 (AZ)
Nurse Practitioner Primary 363L00000X259820 (AZ)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1356911994

Carolyn Dimiceli's National Provider Identifier is 1356911994, issued on Jun 27, 2021. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Phoenix, AZ. The record was last updated on Jun 27, 2025.