Individual
STACEY ANN GOURDOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
2550 W UNION HILLS DR STE 390, PHOENIX, AZ 85027-5197
(602) 443-4068
(623) 434-8310
Mailing address
5151 E BROADWAY RD STE 107, MESA, AZ 85206-1346
(480) 290-7000
(602) 254-6840
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
RN060766
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP2224
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332832
—
AZ
Enumeration date
07/05/2006
Last updated
10/07/2025
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