Healthcare Provider Details

I. General information

NPI: 1427043496
Provider Name (Legal Business Name): SHAUNA L BINETTE A.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHAUNA L WALPOLE A.N.P.

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 E ARBOR AVE #101
MESA AZ
85206-6102
US

IV. Provider business mailing address

3707 N 7TH ST #305
PHOENIX AZ
85014-5059
US

V. Phone/Fax

Practice location:
  • Phone: 480-985-1700
  • Fax: 480-396-3659
Mailing address:
  • Phone: 602-264-9100
  • Fax: 602-264-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN088438
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP1734
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: