MEDICARE: RESIDENTIAL PRESCRIPTIVE SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1265315782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDENTIAL PRESCRIPTIVE SERVICES PLLC

Provider Business Mailing Address
First Line	:	2942 N 24TH ST STE 115
Second Line	:	PMB 874450
City	:	PHOENIX
State	:	AZ
Zip	:	85016-7849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4940 S 162ND ST
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85298-8466
Country	:	US
Telephone Number	:	480-388-5818
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KEITH BRASFIELD
Credential	:
Telephone Number	:	480-388-5818

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	12/11/2025

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