Provider Demographics
NPI:1396898458
Name:THE ELDERLY ADVOCATE INC.
Entity type:Organization
Organization Name:THE ELDERLY ADVOCATE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRIS-STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, AGNP
Authorized Official - Phone:602-486-8155
Mailing Address - Street 1:PO BOX 8306
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85252-8306
Mailing Address - Country:US
Mailing Address - Phone:602-486-8155
Mailing Address - Fax:623-587-0839
Practice Address - Street 1:4040 E MCDOWELL RD
Practice Address - Street 2:SUITE # 214
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4414
Practice Address - Country:US
Practice Address - Phone:602-486-8155
Practice Address - Fax:623-587-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN053710363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ21347Medicare ID - Type UnspecifiedPROVIDER ID #