Healthcare Provider Details

I. General information

NPI: 1306148721
Provider Name (Legal Business Name): MEREDITH BOHNE ESNER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16427 N SCOTTSDALE RD STE 100
SCOTTSDALE AZ
85254-8197
US

IV. Provider business mailing address

3225 N CIVIC CENTER PLZ STE1
SCOTTSDALE AZ
85251-6919
US

V. Phone/Fax

Practice location:
  • Phone: 480-718-5072
  • Fax: 480-715-5074
Mailing address:
  • Phone: 480-246-3000
  • Fax: 480-246-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number4711
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: