Healthcare Provider Details

I. General information

NPI: 1932106192
Provider Name (Legal Business Name): JANINE SUTTER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2005
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15425 N GREENWAY HAYDEN LOOP STE A300
SCOTTSDALE AZ
85260
US

IV. Provider business mailing address

7127 E LAKEVIEW AVE
MESA AZ
85209-4813
US

V. Phone/Fax

Practice location:
  • Phone: 480-607-1124
  • Fax: 480-607-1087
Mailing address:
  • Phone: 480-361-3882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP1713
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: