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NPI Code Detail

MEDICARE: MR. BRETT LEE LEIFSON APRN MSN PMHNP-BC

MEDICARE: MR. BRETT LEE LEIFSON APRN MSN PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAP10361AZ

General Provider Information

NPI Number : 1003338518
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRETT LEE LEIFSON APRN MSN PMHNP-BC
Provider Business Mailing Address
First Line : 7373 N SCOTTSDALE RD STE A199
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85253-3593
Country : US
Telephone Number : 702-805-5360
Fax Number : 702-977-7488
Provider Business Practice Location Address
First Line : 7373 N SCOTTSDALE RD STE A199
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85253-3593
Country : US
Telephone Number : 702-805-5360
Fax Number : 702-977-7488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2017
Last Update Date : 09/06/2024

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