Healthcare Provider Details

I. General information

NPI: 1336054964
Provider Name (Legal Business Name): INTEGRATED CARE PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WEST ST STE 1200
WILMINGTON DE
19801-1058
US

IV. Provider business mailing address

2375 E CAMELBACK RD STE 600
PHOENIX AZ
85016-3493
US

V. Phone/Fax

Practice location:
  • Phone: 602-387-4001
  • Fax: 615-479-9760
Mailing address:
  • Phone: 602-387-4001
  • Fax:

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: KIRK STANLEY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 615-479-9760