Healthcare Provider Details

I. General information

NPI: 1124956404
Provider Name (Legal Business Name): LISA COPE FLOWER DNP APRN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 N 25TH ST APT 15
PHOENIX AZ
85016-5667
US

IV. Provider business mailing address

4220 N 25TH ST APT 15
PHOENIX AZ
85016-5667
US

V. Phone/Fax

Practice location:
  • Phone: 480-531-3077
  • Fax:
Mailing address:
  • Phone: 480-531-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNRNP338871
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: