Healthcare Provider Details
I. General information
NPI: 1821928300
Provider Name (Legal Business Name): BREANNA SHRABLE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6232 N 7TH ST STE 101
PHOENIX AZ
85014-1850
US
IV. Provider business mailing address
8110 N HICKORY ST APT 14-037
KANSAS CITY MO
64118-6431
US
V. Phone/Fax
- Phone: 623-233-0914
- Fax: 623-321-6050
- Phone: 816-519-9963
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 2021020930 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 343052 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: