Healthcare Provider Details

I. General information

NPI: 1710567300
Provider Name (Legal Business Name): CODY JEAN MILLER-MUNOZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 09/27/2025
Certification Date: 09/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 32ND ST
PHOENIX AZ
85008-6205
US

IV. Provider business mailing address

400 N 32ND ST
PHOENIX AZ
85008-6205
US

V. Phone/Fax

Practice location:
  • Phone: 602-914-2900
  • Fax:
Mailing address:
  • Phone: 602-914-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number71174
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: