MEDICARE: STEPHANIE HERRICK KAYS FNP

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	363LF0000X	Family Nurse Practitioner	AP7363	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962806372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE HERRICK KAYS FNP

Provider Business Mailing Address
First Line	:	2525 W CAREFREE HWY STE 102
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085-9302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 W CAMELBACK RD BLDG 47
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85017-1097
Country	:	US
Telephone Number	:	602-639-6215
Fax Number	:	602-936-7830

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

Provider Enumeration Date	:	10/14/2014
Last Update Date	:	03/13/2021

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