NPI 1477584118 · live from the CMS NPI Registry
Stacey Ann Gourdoux, ANP-C
Nurse Practitioner, Adult Health in Phoenix, AZ. National Provider Identifier 1477584118, active.
NPI record
| NPI | 1477584118 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Adult Health 363LA2200X |
| Practice location | 2550 W Union Hills Dr Ste 390, Phoenix, AZ 85027 |
| Practice phone | 602-443-4068 |
| Mailing address | 5151 E Broadway Rd Ste 107, Mesa, AZ 85206 |
| Enumerated | July 5, 2006 |
| Last updated | October 7, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, General Practice | 163WG0000X | RN060766 (AZ) |
| Nurse Practitioner, Adult Health primary | 363LA2200X | AP2224 (AZ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.