Provider Demographics
NPI:1275140972
Name:JOHNS CALIGIURI, STACY KIT (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:KIT
Last Name:JOHNS CALIGIURI
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5309
Mailing Address - Country:US
Mailing Address - Phone:602-604-0000
Mailing Address - Fax:602-604-5863
Practice Address - Street 1:950 W ELLIOT RD STE 201
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1145
Practice Address - Country:US
Practice Address - Phone:480-741-4871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-26
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ255641363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ255641OtherAZ STATE BOARD OF NURSING
AZ23355143OtherNCSBN