MEDICARE: CARLI ENDSLEY

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	363A00000X	Physician Assistant	11378	AZ

General Provider Information

NPI Number	:	1972319671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLI ENDSLEY

Provider Business Mailing Address
First Line	:	325 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6589
Country	:	US
Telephone Number	:	602-243-7277
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6589
Country	:	US
Telephone Number	:	602-243-7277
Fax Number	:

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

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	01/10/2026

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Directions to “ CARLI ENDSLEY ” Practice Location

Language	Start Address	Practice Location

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