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Contact Information

MARY GDULA, FNP
1 CLINIC ROAD
GRAND CANYON VILLAGE, AZ86023
 Phone: 928-213-6121
 Fax: 928-213-6136
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for MARY GDULA · (Female)

NPI Number 1124092242
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 02/15/2006
Last updated 10/22/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # AP1443
  • AZ License # RN116942
  • AZ Other 764755 AHCCCS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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