Healthcare Provider Details

I. General information

NPI: 1083447338
Provider Name (Legal Business Name): FUNCTION FIRST PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 W UNION HILLS DR STE 350
PHOENIX AZ
85027-5187
US

IV. Provider business mailing address

2550 W UNION HILLS DR STE 350
PHOENIX AZ
85027-5187
US

V. Phone/Fax

Practice location:
  • Phone: 888-742-1392
  • Fax:
Mailing address:
  • Phone: 888-742-1392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. APRIL R ELLIS
Title or Position: PARTNER
Credential: PMHNP-BC
Phone: 480-600-8472