Provider Demographics
NPI:1548955297
Name:PROSKEY, RONALD JOSEPH (NP)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JOSEPH
Last Name:PROSKEY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:RONALD
Other - Middle Name:JOSEPH
Other - Last Name:PROSKEY
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1406 N VINCENT CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-4402
Mailing Address - Country:US
Mailing Address - Phone:480-702-4560
Mailing Address - Fax:520-542-3362
Practice Address - Street 1:1520 E PIMA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-4639
Practice Address - Country:US
Practice Address - Phone:602-407-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ289148363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health