Provider Demographics
NPI:1831191329
Name:HARRISON, MAUREEN KEIGHER (FNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:KEIGHER
Last Name:HARRISON
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 1:5519 S COMPASS RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1932
Mailing Address - Country:US
Mailing Address - Phone:480-831-6738
Mailing Address - Fax:480-831-6759
Practice Address - Street 1:8117 E ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85257-3818
Practice Address - Country:US
Practice Address - Phone:480-941-9283
Practice Address - Fax:480-941-9286
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN043185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ014299OtherBLUE CROSS BLUE SHIELD
AZAZ014299OtherBLUE CROSS BLUE SHIELD
AZ103917Medicare ID - Type Unspecified