Healthcare Provider Details

I. General information

NPI: 1811677875
Provider Name (Legal Business Name): ELIZABETH A SHRADER, DNP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 E RAY RD STE 114
GILBERT AZ
85296-4205
US

IV. Provider business mailing address

633 E RAY RD STE 114
GILBERT AZ
85296-4205
US

V. Phone/Fax

Practice location:
  • Phone: 602-671-3091
  • Fax: 602-563-8170
Mailing address:
  • Phone: 602-671-3091
  • Fax: 602-563-8170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH ANN SHRADER
Title or Position: PMHNP-BC, WHNP-BC
Credential: DNP
Phone: 602-671-3091