MEDICARE: ELIZABETH A SHRADER, DNP, PLLC

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	363LW0102X	Women's Health Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1811677875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZABETH A SHRADER, DNP, PLLC

Provider Business Mailing Address
First Line	:	633 E RAY RD STE 114
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-4205
Country	:	US
Telephone Number	:	602-671-3091
Fax Number	:	602-563-8170

Provider Business Practice Location Address
First Line	:	633 E RAY RD STE 114
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-4205
Country	:	US
Telephone Number	:	602-671-3091
Fax Number	:	602-563-8170

Authorized Official
Title or Position	:	PMHNP-BC, WHNP-BC
Name	:	MRS. ELIZABETH ANN SHRADER
Credential	:	DNP
Telephone Number	:	602-671-3091

Provider Enumeration Date	:	07/24/2023
Last Update Date	:	05/09/2025

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