Provider Demographics
NPI:1497145841
Name:SUNSHINE, NANCY (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:SUNSHINE
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:PO BOX 72090
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1019
Mailing Address - Country:US
Mailing Address - Phone:480-361-7680
Mailing Address - Fax:480-361-7683
Practice Address - Street 1:2451 S WHITE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-7306
Practice Address - Country:US
Practice Address - Phone:928-532-7599
Practice Address - Fax:928-532-8599
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN094427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAP7414OtherAP LIC