Healthcare Provider Details

I. General information

NPI: 1003625997
Provider Name (Legal Business Name): KRISTA JANISZEWSKI BAUER MSN, FNP-C, WCC, OMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 N 92ND ST
SCOTTSDALE AZ
85258-4509
US

IV. Provider business mailing address

10210 N 92ND ST
SCOTTSDALE AZ
85258-4509
US

V. Phone/Fax

Practice location:
  • Phone: 480-493-0900
  • Fax:
Mailing address:
  • Phone: 480-493-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number318838
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN164452
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: