Healthcare Provider Details

I. General information

NPI: 1417897877
Provider Name (Legal Business Name): CINDY STAPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1934 E CAMELBACK RD STE 110
PHOENIX AZ
85016-4136
US

IV. Provider business mailing address

6984 W BLACKHAWK DR
GLENDALE AZ
85308-9446
US

V. Phone/Fax

Practice location:
  • Phone: 602-878-4405
  • Fax:
Mailing address:
  • Phone: 916-798-5247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: