Healthcare Provider Details

I. General information

NPI: 1790679975
Provider Name (Legal Business Name): MEGAN FRANCES STANLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
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

4455 NOTTINGHAM LN
IDAHO FALLS ID
83402-5121
US

V. Phone/Fax

Practice location:
  • Phone: 623-233-0914
  • Fax: 623-321-6050
Mailing address:
  • Phone: 208-709-3378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number2561071
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number293562
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number293562
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: