Provider Demographics
NPI:1043812142
Name:PACK, HOPE ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:HOPE
Middle Name:ELIZABETH
Last Name:PACK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-5277
Mailing Address - Country:US
Mailing Address - Phone:602-989-2193
Mailing Address - Fax:
Practice Address - Street 1:9305 W THOMAS RD STE 305
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3366
Practice Address - Country:US
Practice Address - Phone:623-478-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ249394363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily