Healthcare Provider Details

I. General information

NPI: 1831588516
Provider Name (Legal Business Name): STACEY LYNN MCANDREWS PMHNP/FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STACEY LYNN DUNN FNP

II. Dates (important events)

Enumeration Date: 01/17/2015
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 E PIMA ST
PHOENIX AZ
85034-4639
US

IV. Provider business mailing address

6445 S HONOR CT
GILBERT AZ
85298-4894
US

V. Phone/Fax

Practice location:
  • Phone: 602-407-6280
  • Fax:
Mailing address:
  • Phone: 602-920-1462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024173627
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP7546
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP7546
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: