Provider Demographics
NPI:1154407666
Name:FLOYD, IESHA RASHEDA (FNP)
Entity type:Individual
Prefix:MRS
First Name:IESHA
Middle Name:RASHEDA
Last Name:FLOYD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 W NORTHERN AVE STE B210
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-9336
Mailing Address - Country:US
Mailing Address - Phone:480-963-1853
Mailing Address - Fax:
Practice Address - Street 1:2228 W NORTHERN AVE STE B210
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-9336
Practice Address - Country:US
Practice Address - Phone:480-963-1853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN134731163WS0200X
AZ256272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ124823Medicare UPIN