Healthcare Provider Details

I. General information

NPI: 1801600606
Provider Name (Legal Business Name): MICHELLE NASSEEF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6461 E BAYWOOD AVE
MESA AZ
85206-1744
US

IV. Provider business mailing address

2895 S PALM ST
GILBERT AZ
85295-1475
US

V. Phone/Fax

Practice location:
  • Phone: 480-832-5160
  • Fax:
Mailing address:
  • Phone: 480-717-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number236042
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: