MEDICARE: MARCI BASTIEN NP

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP5721	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811304272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI BASTIEN NP

Provider Business Mailing Address
First Line	:	3003 N CENTRAL AVE
Second Line	:	SUITE 200
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2902
Country	:	US
Telephone Number	:	602-685-6000
Fax Number	:	602-302-7925

Provider Business Practice Location Address
First Line	:	2355 E CAMELBACK RD STE 625
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-3458
Country	:	US
Telephone Number	:	480-626-7584
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	11/20/2025

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