Healthcare Provider Details

I. General information

NPI: 1457149114
Provider Name (Legal Business Name): DAVID MYRZA PHMNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6232 N 7TH ST STE 101
PHOENIX AZ
85014-1850
US

IV. Provider business mailing address

8320 W CATALINA DR
PHOENIX AZ
85037-3344
US

V. Phone/Fax

Practice location:
  • Phone: 623-233-0914
  • Fax:
Mailing address:
  • Phone: 916-897-1340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number218842
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: