Healthcare Provider Details

I. General information

NPI: 1235326620
Provider Name (Legal Business Name): STEPHANIE R WINTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 E MCKELLIPS RD
MESA AZ
85203-2721
US

IV. Provider business mailing address

19829 N 27TH AVE
PHOENIX AZ
85027-4001
US

V. Phone/Fax

Practice location:
  • Phone: 480-833-1800
  • Fax:
Mailing address:
  • Phone: 623-879-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2953
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN145151
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: