Healthcare Provider Details

I. General information

NPI: 1699262519
Provider Name (Legal Business Name): RHIANNON JOY WHISLER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18555 N 79TH AVE STE D101
GLENDALE AZ
85308-6040
US

IV. Provider business mailing address

6366 W SAINT JOHN AVE
GLENDALE AZ
85308-3620
US

V. Phone/Fax

Practice location:
  • Phone: 602-726-9781
  • Fax:
Mailing address:
  • Phone: 602-726-9781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP11355
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN131627
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: