Healthcare Provider Details

I. General information

NPI: 1609350271
Provider Name (Legal Business Name): ASHLEY ARCHER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7227 E BASELINE RD STE 126
MESA AZ
85209-5006
US

IV. Provider business mailing address

38734 N JOANN WAY
SAN TAN VALLEY AZ
85140-4024
US

V. Phone/Fax

Practice location:
  • Phone: 480-868-9650
  • Fax: 480-834-3606
Mailing address:
  • Phone: 480-334-4763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11747
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: