Provider Demographics
NPI:1518582477
Name:SHIRLEY, PATRICIA (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SHIRLEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38292 N AMY LN
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-4159
Mailing Address - Country:US
Mailing Address - Phone:402-208-1535
Mailing Address - Fax:
Practice Address - Street 1:8765 E BELL RD STE 104
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1320
Practice Address - Country:US
Practice Address - Phone:480-970-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ242513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily