Healthcare Provider Details

I. General information

NPI: 1972417798
Provider Name (Legal Business Name): SUNSHINE ROWDY ERISMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CAMELBACK RD STE 108
PHOENIX AZ
85012-1061
US

IV. Provider business mailing address

901 S ALMA SCHOOL RD APT 59
CHANDLER AZ
85224-0907
US

V. Phone/Fax

Practice location:
  • Phone: 602-354-3925
  • Fax:
Mailing address:
  • Phone: 406-930-1673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number24419880
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: