Healthcare Provider Details

I. General information

NPI: 1801742051
Provider Name (Legal Business Name): MS. STEPHANIE DEHARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 E SHEA BLVD
SCOTTSDALE AZ
85254-6162
US

IV. Provider business mailing address

10532 N 79TH ST
SCOTTSDALE AZ
85258-1237
US

V. Phone/Fax

Practice location:
  • Phone: 602-283-2355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN338420
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: