Healthcare Provider Details

I. General information

NPI: 1598210643
Provider Name (Legal Business Name): PAMELA L PERRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 08/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14301 N 87TH ST SUITE 315
SCOTTSDALE AZ
85260-3686
US

IV. Provider business mailing address

14301 N 87TH ST SUITE 315
SCOTTSDALE AZ
85260-3686
US

V. Phone/Fax

Practice location:
  • Phone: 480-482-0867
  • Fax: 480-483-5014
Mailing address:
  • Phone: 480-482-0867
  • Fax: 480-483-5014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAMELA L PERRY
Title or Position: OWNER
Credential: NP
Phone: 480-818-0125