Healthcare Provider Details

I. General information

NPI: 1093660870
Provider Name (Legal Business Name): WATER LILY HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E EARLL DR UNIT 628
PHOENIX AZ
85012-0034
US

IV. Provider business mailing address

400 E EARLL DR UNIT 628
PHOENIX AZ
85012-0034
US

V. Phone/Fax

Practice location:
  • Phone: 480-712-0628
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FARHANA AFRIN
Title or Position: NURSE PRACTITIONER
Credential: DNP
Phone: 480-712-0628