Healthcare Provider Details

I. General information

NPI: 1386572287
Provider Name (Legal Business Name): MIKAYLA SCHUPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4323 E JUNCTION DR
APACHE JUNCTION AZ
85119-9365
US

IV. Provider business mailing address

4323 E JUNCTION DR
APACHE JUNCTION AZ
85119-9365
US

V. Phone/Fax

Practice location:
  • Phone: 360-751-1536
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226731
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: