Healthcare Provider Details

I. General information

NPI: 1467339721
Provider Name (Legal Business Name): GHADEER HURAISH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 S MCQUEEN RD
CHANDLER AZ
85225-6403
US

IV. Provider business mailing address

401 S MCQUEEN RD
CHANDLER AZ
85225-6403
US

V. Phone/Fax

Practice location:
  • Phone: 480-883-5702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number316755
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: