Healthcare Provider Details

I. General information

NPI: 1902647779
Provider Name (Legal Business Name): ESTHER QUEEN AMUZIE PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 N 16TH ST STE 102
PHOENIX AZ
85020-5266
US

IV. Provider business mailing address

7301 N 16TH ST STE 102
PHOENIX AZ
85020-5266
US

V. Phone/Fax

Practice location:
  • Phone: 480-896-2124
  • Fax: 480-896-2123
Mailing address:
  • Phone: 480-896-2124
  • Fax: 480-896-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number308434
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: