Healthcare Provider Details

I. General information

NPI: 1720725625
Provider Name (Legal Business Name): ACACIA S HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23864 N 166TH LN
SURPRISE AZ
85387-1460
US

IV. Provider business mailing address

23864 N 166TH LN
SURPRISE AZ
85387-1460
US

V. Phone/Fax

Practice location:
  • Phone: 609-364-4028
  • Fax:
Mailing address:
  • Phone: 609-364-4028
  • Fax: 602-322-9817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JANET D TATE-BROWN
Title or Position: NURSE PRACTITIONER
Credential: DNP, FNP-BC
Phone: 609-364-4028