Basic Information
| Provider Information | |||||||||
| NPI: | 1700319605 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | STUFF | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | LEA | ||||||||
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| Credential: | PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4531 N 16TH ST STE 114 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850165344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022668700 | ||||||||
| FaxNumber: | 6022960404 | ||||||||
| Practice Location | |||||||||
| Address1: | 7400 S POWER RD STE 126 | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852979283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804827350 | ||||||||
| FaxNumber: | 4804827370 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2017 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AP9954 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 363LF0000X | AP9954 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.