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General NPI Number Information
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NPI Number | 1376346429
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Entity Type | Individual
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Provider Name | ELAINE HUMPHRIES
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Gender |
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 10210 N 92ND ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-4509
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Country | US
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Telephone | 480-493-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 11186 S INDIAN WELLS DR
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City | GOODYEAR
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State | AZ
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Zip | 85338-5465
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Country | US
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Telephone |
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 224079
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License Number State | AZ
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