STEPHANIE TAVENER (NPI# 1710160106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710160106 |
| Entity Type | Individual |
| Full Name | STEPHANIE TAVENER |
| Credential | PA |
| Practice Address |
1250 S Clearview Ave 100 Mesa AZ 85209-3378 |
| Mailing Address |
1343 N Alma School Rd Ste 160 Chandler AZ 85224-5901 |
| Practice Telephone | 4804234670 |
| Mailing Telephone | 4809631853 |
| Mailing Fax Number | 4809631854 |
| Enumeration Date | 2007-12-09 |
| Last Update Date | 2018-01-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5115 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ARIZONA LICENSE | 5115 | 01 |
| Street Address |
1250 S CLEARVIEW AVE 100 |
| City | MESA |
| State | AZ |
| Zip Code | 85209-3378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548236862 | Amelia Rose Farnbach | Physician Assistant | 1250 S Clearview Ave, 100, Mesa, AZ 85209-3378 | 2006-02-27 |
| 1114466000 | Ucxtra Air, LLC | Ambulance | 1250 S Clearview Ave, 100, Mesa, AZ 85209-3378 | 2017-02-13 |
| 1083077531 | Patricia Layton | Physician Assistant | 1250 S Clearview Ave, Suite 100, Mesa, AZ 85209-3378 | 2016-04-01 |
| 1386028421 | Ucxtra Umbrella, LLC | Clinic/Center | 1250 S Clearview Ave, Suite 100, Mesa, AZ 85209 | 2015-07-18 |
| 1306228218 | Dana Smith | Nurse Practitioner | 1250 S Clearview Ave, 100, Mesa, AZ 85209-3378 | 2015-06-26 |
| 1033508635 | Shuntelle Hawk | Nurse Practitioner | 1250 S Clearview Ave, Suite 100, Mesa, AZ 85209-3378 | 2015-01-20 |
| 1497195556 | Katherine E Kolb | Physician Assistant | 1250 S Clearview Ave, Suite 100, Mesa, AZ 85209-3378 | 2013-07-02 |
| 1548495997 | Kyla Ballesteros | Physician Assistant | 1250 S Clearview Ave, Suite 100, Mesa, AZ 85209-3378 | 2009-05-28 |
| 1164511341 | Debra Bristol | Nurse Practitioner | 1250 S Clearview Ave, 100, Mesa, AZ 85209-3378 | 2006-10-12 |
| 1821190828 | Peggy L Lucas | Nurse Practitioner | 1250 S Clearview Ave, 100, Mesa, AZ 85209-3378 | 2006-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
| 1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
| 1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
| 1174012934 | Andrew Swenson | Student in an Organized Health Care Education/Training Program | 10238 E. Hampton #406, Mesa, AZ 85209 | 2018-05-08 |
| 1689196057 | Monica R Meyer | Registered Nurse | 2424 S Rowen, Mesa, AZ 85209 | 2017-07-07 |
| 1629507041 | Rachel Ann Navarro | Occupational Therapist | 10431 E Natal Ave, Mesa, AZ 85209 | 2017-06-08 |
| 1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
| 1275069569 | Michelle Amado | Nurse Practitioner | 2500 S. Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-04 |
| 1982138079 | Warren Brent Thomas | Nurse Anesthetist, Certified Registered | 10632 E Kiva Ave, Mesa, AZ 85209 | 2017-04-14 |
| Find all providers in zip 85209 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962986349 | Amber Lynn Maison | Physician Assistant | 4540 E Baseline Rd Ste 113, Mesa, AZ 85206-4617 | 2018-09-20 |
| 1821549619 | Briana Dawn Johnson | Physician Assistant | 455 N Mesa Dr Ste 16e, Mesa, AZ 85201-5995 | 2016-10-17 |
| 1659741031 | Jared Bevell | Physician Assistant | 844 E 7th Pl, Mesa, AZ 85203-6404 | 2015-09-29 |
| 1649507088 | Klint Layton Webb | Physician Assistant | 3130 E Baseline Rd Ste 103-104, Mesa, AZ 85204-7290 | 2009-11-05 |
| 1194961540 | Jeffrey R Smolin | Physician Assistant | 2034 S Alma School Rd Ste 2, Mesa, AZ 85210-4004 | 2009-01-06 |
| 1235389156 | Tessa M Tibben | Physician Assistant | 4855 E Brown Rd Ste 100, Mesa, AZ 85205-8007 | 2008-09-27 |
| 1639353808 | Brittany S Wheeler | Physician Assistant | 2310 E. Brown Rd, Mesa, AZ 85213 | 2007-12-24 |
| 1891995296 | Kellie M Earle P.a. | Physician Assistant | 4135 So. Power Rd, Suite 129, Mesa, AZ 85212 | 2007-07-23 |
| 1881778348 | Robert James Kalmbach | Physician Assistant | 4850 E Baseline #118, Mesa, AZ 85206 | 2006-10-24 |
| 1336255264 | Greenfield Family Medicine LLC | Physician Assistant | 1244 N. Greenfield Rd., Suite 104, Mesa, AZ 85205 | 2006-08-22 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.