MEDICARE: MRS. KARLA S DEZORZI 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	AP0806	AZ

General Provider Information

NPI Number	:	1649370248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARLA S DEZORZI PMHNP-BC

Provider Business Mailing Address
First Line	:	8286 N SABLE WAY
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86315-7827
Country	:	US
Telephone Number	:	928-379-7053
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E MISSOURI AVE STE 340
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-2753
Country	:	US
Telephone Number	:	928-379-7053
Fax Number	:

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	01/13/2025

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