Healthcare Provider Details

I. General information

NPI: 1093540866
Provider Name (Legal Business Name): MAGGIE TALAMANTES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 N 32ND PL
PHOENIX AZ
85028-2703
US

IV. Provider business mailing address

7272 E INDIAN SCHOOL RD STE 540
SCOTTSDALE AZ
85251-3996
US

V. Phone/Fax

Practice location:
  • Phone: 480-772-8062
  • Fax:
Mailing address:
  • Phone: 480-207-5205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number314188
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: