Healthcare Provider Details

I. General information

NPI: 1811304272
Provider Name (Legal Business Name): MARCI BASTIEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 E CAMELBACK RD STE 625
PHOENIX AZ
85016-3458
US

IV. Provider business mailing address

3003 N CENTRAL AVE SUITE 200
PHOENIX AZ
85012-2902
US

V. Phone/Fax

Practice location:
  • Phone: 480-626-7584
  • Fax:
Mailing address:
  • Phone: 602-685-6000
  • Fax: 602-302-7925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP5721
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: