Dale Ann Manzoeillo, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP2462 Issued in AZ

Practice address

4315 N Maryvale Pkwy
Phoenix, AZ 85031-1942

Phone

(602) 243-7277

Fax

(623) 691-1770

NPI assigned

Jul 18, 2007

Last updated

Nov 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1669878567
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1669672697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 N 3RD ST STE 4020",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044608",
            "telephone_number": "602-323-3492",
            "fax_number": "602-323-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 N MARYVALE PKWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311942",
            "telephone_number": "602-243-7277",
            "fax_number": "623-691-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZOEILLO",
        "first_name": "DALE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP2462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230765",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11774490",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Ray Manuel, ATC/LAT
• Samuel Lamar Manuel
• Allison Elizabeth Manweiler, PA-C
• Lindsey N Manz, RD
• Manzanita Medical PLLC
• Khalid Manzoul, MD
• Lucinda Mapalo
• Briane Jeniene Mape, DNP, FNP-BC
• Jamie Mapes, RN
• Maple Street ABA Az LLC

• Pediatric Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.