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General NPI Number Information
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NPI Number | 1114233806
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Entity Type | Individual
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Provider Name | ELIZABETH M HALLSTROM FNP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 9500 E IRONWOOD SQUARE DR STE 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4582
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Country | US
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Telephone | 480-948-8400
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Fax | 480-948-8401
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Provider Business Mailing Address
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Address Line | 9500 E IRONWOOD SQUARE DR STE 110
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4582
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Country | US
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Telephone | 480-948-8400
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Fax | 480-948-8401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN00059
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 230160
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License Number State | AZ
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