Healthcare Provider Details

I. General information

NPI: 1043470503
Provider Name (Legal Business Name): NICOLE DANIELLE GARBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13945 W GRAND AVE STE 104
SURPRISE AZ
85374-2437
US

IV. Provider business mailing address

6677 W THUNDERBIRD RD STE I164
GLENDALE AZ
85306-3762
US

V. Phone/Fax

Practice location:
  • Phone: 623-878-2100
  • Fax: 623-776-9419
Mailing address:
  • Phone: 623-878-2100
  • Fax: 623-776-9419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number65030
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number8177
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: