Shalissa Marie Easley, FNP-C
Nurse Practitioner, Family in Phoenix, AZ. Individual provider (NPI-1).
NPI number1982303368
StatusActive
Last updated in NPPESMay 15, 2023
Details
- NPI
- 1982303368
- Entity type
- Individual (NPI-1)
- Name
- Shalissa Marie Easley
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 24, 2023
- Certification date
- May 15, 2023
- Last updated
- May 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 287086 | AZ | Yes |
Practice location
3201 W Peoria Ave Ste C500Phoenix, AZ 85029-4600
Phone 623-773-2000
Mailing address
3201 W Peoria Ave Ste C500Phoenix, AZ 85029-4600
Phone 623-773-2000
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