Healthcare Provider Details

I. General information

NPI: 1750198024
Provider Name (Legal Business Name): MERCY KINYANJUI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37000 N GANTZEL RD
QUEEN CREEK AZ
85140-7303
US

IV. Provider business mailing address

22616 E EXCELSIOR AVE
QUEEN CREEK AZ
85142-2140
US

V. Phone/Fax

Practice location:
  • Phone: 480-394-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number310144
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number310144
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: