Provider Demographics
NPI:1508132820
Name:ELLOWAY, ARLEEN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ARLEEN
Middle Name:
Last Name:ELLOWAY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ARLEEN
Other - Middle Name:
Other - Last Name:STIENSTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:18417 N 20TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-1422
Mailing Address - Country:US
Mailing Address - Phone:602-505-1924
Mailing Address - Fax:480-775-2425
Practice Address - Street 1:824 N 99TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-5324
Practice Address - Country:US
Practice Address - Phone:623-907-6520
Practice Address - Fax:480-775-2425
Is Sole Proprietor?:No
Enumeration Date:2012-03-30
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP4358363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner