Provider Demographics
NPI:1811677875
Name:ELIZABETH A SHRADER, DNP, PLLC
Entity type:Organization
Organization Name:ELIZABETH A SHRADER, DNP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC, WHNP-BC
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHRADER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:602-671-3091
Mailing Address - Street 1:633 E RAY RD STE 114
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-4205
Mailing Address - Country:US
Mailing Address - Phone:602-671-3091
Mailing Address - Fax:602-563-8170
Practice Address - Street 1:633 E RAY RD STE 114
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4205
Practice Address - Country:US
Practice Address - Phone:602-671-3091
Practice Address - Fax:602-563-8170
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELIZABETH A SHRADER, DNP, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-24
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty