Healthcare Provider Details

I. General information

NPI: 1629020912
Provider Name (Legal Business Name): PAUL STERRETT N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9069 W THUNDERBIRD RD
PEORIA AZ
85381
US

IV. Provider business mailing address

25500 N NORTERRA DR
PHOENIX AZ
85085
US

V. Phone/Fax

Practice location:
  • Phone: 623-977-7201
  • Fax: 623-876-2389
Mailing address:
  • Phone: 623-277-1130
  • Fax: 866-837-6575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN073682
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP2354
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: