Healthcare Provider Details

I. General information

NPI: 1609702158
Provider Name (Legal Business Name): INTEGRATED CARE PHYSICIANS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 ALAMO AVE SE STE 300
ALBUQUERQUE NM
87106-3523
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:
  • 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: 602-387-4001