Healthcare Provider Details

I. General information

NPI: 1063913986
Provider Name (Legal Business Name): TARA LYNN DENTON MSN, APRN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 N 32ND ST STE 200
PHOENIX AZ
85018-6218
US

IV. Provider business mailing address

3125 N 32ND ST STE 200
PHOENIX AZ
85018-6218
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-7481
  • Fax: 602-956-7591
Mailing address:
  • Phone: 602-956-7481
  • Fax: 602-956-7591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number3011998
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: