Healthcare Provider Details

I. General information

NPI: 1780167155
Provider Name (Legal Business Name): AMY HOAGLAND ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 01/06/2023
Certification Date: 10/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 E SHEA BLVD STE 100
SCOTTSDALE AZ
85260-6635
US

IV. Provider business mailing address

8725 E SAN FELIPE DR
SCOTTSDALE AZ
85258-2626
US

V. Phone/Fax

Practice location:
  • Phone: 602-755-3441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP11774
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: