MEDICARE: RISING LOTUS HEALING LLC

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

General Provider Information

NPI Number	:	1700356409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING LOTUS HEALING LLC

Provider Business Mailing Address
First Line	:	16601 N 40TH ST STE 216
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3354
Country	:	US
Telephone Number	:	928-550-8002
Fax Number	:	928-707-8500

Provider Business Practice Location Address
First Line	:	16601 N 40TH ST STE 216
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3354
Country	:	US
Telephone Number	:	928-550-8002
Fax Number	:	928-707-8500

Authorized Official
Title or Position	:	MANAGER
Name	:	STEPHEN TAYLOR
Credential	:	PMHNP-BC
Telephone Number	:	928-457-2727

Provider Enumeration Date	:	11/26/2018
Last Update Date	:	06/16/2026

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Directions to “RISING LOTUS HEALING LLC ” Practice Location

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