Healthcare Provider Details

I. General information

NPI: 1780517219
Provider Name (Legal Business Name): AXISPOINT PSYCHIATRYLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1166 E WARNER RD STE 101
GILBERT AZ
85296-3065
US

IV. Provider business mailing address

1166 E WARNER RD STE 101
GILBERT AZ
85296-3065
US

V. Phone/Fax

Practice location:
  • Phone: 480-910-2039
  • Fax: 480-866-0149
Mailing address:
  • Phone: 480-910-2039
  • Fax: 480-866-0149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAURA PORTER
Title or Position: OWNER/PROVIDER
Credential: MN
Phone: 480-910-2039