Healthcare Provider Details

I. General information

NPI: 1144885831
Provider Name (Legal Business Name): SHELBY NICOLE SCHWEITZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELBY NICOLE ALFRED FNP-BC

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 E BELL RD STE 207
PHOENIX AZ
85032-2159
US

IV. Provider business mailing address

4318 E DESERT SKY CT
CAVE CREEK AZ
85331-5016
US

V. Phone/Fax

Practice location:
  • Phone: 602-971-8200
  • Fax: 602-971-8201
Mailing address:
  • Phone: 602-376-0195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number225213
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: