MEDICARE: CAREEN LYNETTE SISK PMHNP-BC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	332858	AZ

General Provider Information

NPI Number	:	1518821222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAREEN LYNETTE SISK PMHNP-BC

Provider Business Mailing Address
First Line	:	4140 E BASELINE RD STE 101
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 E BASELINE RD STE 101
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4413
Country	:	US
Telephone Number	:	602-430-8101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ CAREEN LYNETTE SISK PMHNP-BC” Practice Location

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