Healthcare Provider Details

I. General information

NPI: 1366955122
Provider Name (Legal Business Name): ADVANCED HEALTH NP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1955 S VAL VISTA DR STE 126
MESA AZ
85204-7372
US

IV. Provider business mailing address

1955 S VAL VISTA DR STE 126
MESA AZ
85204-7372
US

V. Phone/Fax

Practice location:
  • Phone: 480-272-8944
  • Fax: 480-237-5682
Mailing address:
  • Phone: 480-272-8944
  • Fax: 480-237-5682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP8927
License Number StateAZ

VIII. Authorized Official

Name: SHAUN HAMPTON
Title or Position: NURSE PRACTITIONER
Credential: FNP
Phone: 469-559-4368