Healthcare Provider Details

I. General information

NPI: 1023613056
Provider Name (Legal Business Name): JESSICA COTTER MICHIE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA HAINJE

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5499
US

IV. Provider business mailing address

13400 E SHEA BLVD
SCOTTSDALE AZ
85259-5499
US

V. Phone/Fax

Practice location:
  • Phone: 480-301-8000
  • Fax:
Mailing address:
  • Phone: 480-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number288808
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95015887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: