Healthcare Provider Details

I. General information

NPI: 1578040077
Provider Name (Legal Business Name): KATRINA MARIE HAILEY FNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATRINA MARIE LAUER RN, BSN

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 01/13/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E MOUNTAIN VIEW RD STE 120
SCOTTSDALE AZ
85258-5140
US

IV. Provider business mailing address

9201 E MOUNTAIN VIEW RD STE 120
SCOTTSDALE AZ
85258-5140
US

V. Phone/Fax

Practice location:
  • Phone: 623-887-2912
  • Fax: 480-882-5085
Mailing address:
  • Phone: 623-887-2912
  • Fax: 480-882-5085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP11624
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11624
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN174012
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: