Healthcare Provider Details

I. General information

NPI: 1124948377
Provider Name (Legal Business Name): AMSARA ARIZONA PROF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 N DRINKWATER BLVD STE 300-44
SCOTTSDALE AZ
85251-3981
US

IV. Provider business mailing address

4250 N DRINKWATER BLVD STE 300-44
SCOTTSDALE AZ
85251-3981
US

V. Phone/Fax

Practice location:
  • Phone: 480-690-8398
  • Fax: 844-749-4353
Mailing address:
  • Phone: 480-690-8398
  • Fax: 844-749-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STELLE SMITH
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 480-690-8398