Provider Demographics
NPI:1619429529
Name:WINTER, STEPHANIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WINTER
Suffix:
Gender:
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16042 N 32ND ST STE A2
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-0024
Mailing Address - Country:US
Mailing Address - Phone:480-300-4761
Mailing Address - Fax:780-903-1607
Practice Address - Street 1:7400 S POWER RD STE 126
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-9283
Practice Address - Country:US
Practice Address - Phone:480-482-7350
Practice Address - Fax:480-482-7370
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10450363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ291225Medicaid