Healthcare Provider Details

I. General information

NPI: 1700540697
Provider Name (Legal Business Name): CHRISTEN MARISSA FOUTS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 E GREENWAY RD
PHOENIX AZ
85032-4548
US

IV. Provider business mailing address

2018 N VAN NESS AVE
TEMPE AZ
85281-1334
US

V. Phone/Fax

Practice location:
  • Phone: 602-325-5577
  • Fax: 415-252-7176
Mailing address:
  • Phone: 602-405-2062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61599650
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number266168
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: