Healthcare Provider Details

I. General information

NPI: 1801849229
Provider Name (Legal Business Name): CATHY SUE SHAPIRO F.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 W BELL RD A-1
GLENDALE AZ
85308-8529
US

IV. Provider business mailing address

7200 W BELL RD A-1
GLENDALE AZ
85308-8529
US

V. Phone/Fax

Practice location:
  • Phone: 623-334-4000
  • Fax: 623-334-4400
Mailing address:
  • Phone: 623-334-4000
  • Fax: 623-334-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number050365
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: