Healthcare Provider Details

I. General information

NPI: 1609731371
Provider Name (Legal Business Name): SKYE LAUREN BLAESING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
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

353 E CHELSEA DR
SAN TAN VALLEY AZ
85140-5112
US

V. Phone/Fax

Practice location:
  • Phone: 623-233-0914
  • Fax:
Mailing address:
  • Phone: 630-938-0291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number324355
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: