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STEPHANIE ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
5102 W CAMPBELL AVE, PHOENIX, AZ 85031-1703
(602) 655-1000
Mailing address
2929 E THOMAS RD, PHOENIX, AZ 85016-8034
(602) 470-5000

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
24866
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP020669
PA

Other

Enumeration date
08/13/2019
Last updated
12/21/2020
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