Healthcare Provider Details

I. General information

NPI: 1023254471
Provider Name (Legal Business Name): SHEILKEELA HOWARD-GURLEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 E SOUTHERN AVE STE B
TEMPE AZ
85282-5209
US

IV. Provider business mailing address

512 E SOUTHERN AVE STE B
TEMPE AZ
85282-5209
US

V. Phone/Fax

Practice location:
  • Phone: 480-378-0573
  • Fax: 949-561-5129
Mailing address:
  • Phone: 480-378-0573
  • Fax: 949-561-5129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN 346230
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN346230
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: