Healthcare Provider Details

I. General information

NPI: 1174207245
Provider Name (Legal Business Name): MONIQUE SOPHIA ZIPPERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16220 N SCOTTSDALE RD STE 300K
SCOTTSDALE AZ
85254-1798
US

IV. Provider business mailing address

16220 N SCOTTSDALE RD STE 300K
SCOTTSDALE AZ
85254-1798
US

V. Phone/Fax

Practice location:
  • Phone: 480-591-8244
  • Fax:
Mailing address:
  • Phone: 480-591-8244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9801
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: