Healthcare Provider Details

I. General information

NPI: 1962408799
Provider Name (Legal Business Name): LINDA LEE STUART-DAVIS DNP, ANP-BC, CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA LEE DAVIS DNP, ANP-BC, CRNFA

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date: 03/17/2006
Reactivation Date: 04/04/2006

III. Provider practice location address

10335 N SCOTTSDALE RD STE F
SCOTTSDALE AZ
85253-1435
US

IV. Provider business mailing address

6616 E PALO VERDE LN
PARADISE VALLEY AZ
85253-5949
US

V. Phone/Fax

Practice location:
  • Phone: 480-650-6804
  • Fax: 480-948-8344
Mailing address:
  • Phone: 480-650-6804
  • Fax: 480-948-8344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number441888
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number41706
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN037791
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN-1639
License Number StateHI
# 5
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number259
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: