Healthcare Provider Details

I. General information

NPI: 1144144361
Provider Name (Legal Business Name): BRANDON STOCKTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18008 W CAMINO DE ORO
SURPRISE AZ
85387-1787
US

IV. Provider business mailing address

18008 W CAMINO DE ORO
SURPRISE AZ
85387-1787
US

V. Phone/Fax

Practice location:
  • Phone: 602-228-8048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number256935
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: