Healthcare Provider Details

I. General information

NPI: 1598441503
Provider Name (Legal Business Name): MIKALI NICOLE FRANS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MIKALI NICOLE BIRT

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16575 W WADDELL RD
SURPRISE AZ
85388-9627
US

IV. Provider business mailing address

16575 W WADDELL RD
SURPRISE AZ
85388-9627
US

V. Phone/Fax

Practice location:
  • Phone: 623-300-9110
  • Fax:
Mailing address:
  • Phone: 602-920-2398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number293966
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: