Healthcare Provider Details

I. General information

NPI: 1124956404
Provider Name (Legal Business Name): LISA COPE FLOWER DNP APRN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12361 W BOLA DR STE 100
SURPRISE AZ
85378-9021
US

IV. Provider business mailing address

12361 W BOLA DR STE 100
SURPRISE AZ
85378-9021
US

V. Phone/Fax

Practice location:
  • Phone: 602-698-7325
  • Fax: 480-500-8430
Mailing address:
  • Phone: 602-698-7325
  • Fax: 480-500-8430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNRNP338871
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: