Healthcare Provider Details

I. General information

NPI: 1972751105
Provider Name (Legal Business Name): DEBORAH SUE REICH WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 W ROSE GARDEN LN SUITE 110
PHOENIX AZ
85027-4028
US

IV. Provider business mailing address

26522 N 51ST DR
PHOENIX AZ
85083-1274
US

V. Phone/Fax

Practice location:
  • Phone: 623-265-7215
  • Fax: 833-465-1462
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP3091
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP3091
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: