Healthcare Provider Details

I. General information

NPI: 1407789654
Provider Name (Legal Business Name): STEVEN ANTHONY NASTASIO JR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1400 S DOBSON RD
MESA AZ
85202-4707
US

IV. Provider business mailing address

706 N HORNE
MESA AZ
85203-6338
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-3350
  • Fax:
Mailing address:
  • Phone: 480-412-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number220711
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: