Healthcare Provider Details

I. General information

NPI: 1700450657
Provider Name (Legal Business Name): RHEA SCHOUSTRA MSC, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RHEA VADEN RN

II. Dates (important events)

Enumeration Date: 05/15/2021
Last Update Date: 05/15/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8329 N 5TH ST
PHOENIX AZ
85020-3406
US

IV. Provider business mailing address

236 E 82ND ST APT 1F
NEW YORK NY
10028-2798
US

V. Phone/Fax

Practice location:
  • Phone: 602-769-5618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number164338
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number164338
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number164338
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number164338
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: