Healthcare Provider Details

I. General information

NPI: 1396679254
Provider Name (Legal Business Name): SUPREME HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

9331 W CROWN KING RD
TOLLESON AZ
85353-5573
US

IV. Provider business mailing address

2632 S 83RD AVE STE 100
PHOENIX AZ
85043-7206
US

V. Phone/Fax

Practice location:
  • Phone: 480-514-6368
  • Fax: 602-560-7326
Mailing address:
  • Phone: 480-514-6368
  • Fax: 602-560-7326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. SHERRI ANN RHODES
Title or Position: CHIEF MEDICAL OFFICER
Credential: DNP
Phone: 304-237-0933