Healthcare Provider Details

I. General information

NPI: 1235088519
Provider Name (Legal Business Name): DESIREE SHANTAE DEMBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8070 E MORGAN TRL
SCOTTSDALE AZ
85258-1227
US

IV. Provider business mailing address

6406 W BARBARA AVE
GLENDALE AZ
85302-7402
US

V. Phone/Fax

Practice location:
  • Phone: 480-566-8684
  • Fax:
Mailing address:
  • Phone: 623-986-2386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-RNP342582
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License NumberRN215759
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: