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NPI Code Detail

MEDICARE: MARY JO STORTZ APRN

MEDICARE: MARY JO STORTZ APRN
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPRN001578NV
2363L00000XNurse PractitionerRN38554NV
3363LF0000XFamily Nurse PractitionerAPRN001578NV
4363LF0000XFamily Nurse PractitionerRN38554NV

General Provider Information

NPI Number : 1285067629
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY JO STORTZ APRN
Provider Business Mailing Address
First Line : PO BOX 33269
Second Line :
City : PHOENIX
State : AZ
Zip : 85067-3269
Country : US
Telephone Number : 602-406-4786
Fax Number : 916-636-4358
Provider Business Practice Location Address
First Line : 3001 SAINT ROSE PKWY
Second Line :
City : HENDERSON
State : NV
Zip : 89052-3839
Country : US
Telephone Number : 702-616-5615
Fax Number : 702-616-5120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2013
Last Update Date : 06/11/2026

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