Healthcare Provider Details

I. General information

NPI: 1033752761
Provider Name (Legal Business Name): LIZABETH JOY STEPHENS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. LIZABETH JOY SHELBY

II. Dates (important events)

Enumeration Date: 10/25/2019
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44150 WEST MARICOPA-CASA GRAND HWY.
MARICOPA AZ
85138
US

IV. Provider business mailing address

44150 WEST MARICOPA-CASA GRAND HWY.
MARICOPA AZ
85138
US

V. Phone/Fax

Practice location:
  • Phone: 520-568-5100
  • Fax: 520-568-5110
Mailing address:
  • Phone: 520-568-5100
  • Fax: 520-568-5110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN109397
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: