Healthcare Provider Details

I. General information

NPI: 1437520525
Provider Name (Legal Business Name): STEPHANIE ELYSE DURST-RAEL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2015
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20745 N SCOTTSDALE RD STE 120
SCOTTSDALE AZ
85255-6595
US

IV. Provider business mailing address

20745 N SCOTTSDALE RD STE 120
SCOTTSDALE AZ
85255-6595
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7510
  • Fax:
Mailing address:
  • Phone: 480-882-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number221821
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number221821
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: