Healthcare Provider Details

I. General information

NPI: 1396898458
Provider Name (Legal Business Name): THE ELDERLY ADVOCATE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 E MCDOWELL RD SUITE # 214
PHOENIX AZ
85008-4414
US

IV. Provider business mailing address

PO BOX 8306
SCOTTSDALE AZ
85252-8306
US

V. Phone/Fax

Practice location:
  • Phone: 602-486-8155
  • Fax: 623-587-0839
Mailing address:
  • Phone: 602-486-8155
  • Fax: 623-587-0839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN053710
License Number StateAZ

VIII. Authorized Official

Name: SHARON FARRIS-STERN
Title or Position: CEO-PRESIDENT
Credential: M.S., A.G.N.P.
Phone: 602-486-8155