Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ideal Self LLC

Organization Family Nurse Practitioner · NPI 1467182774

Ideal Self LLC is a Family Nurse Practitioner in Phoenix, Arizona. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12620 N Cave Creek Rd Ste 10A
Phoenix, AZ 85022-6528
Phone: (623) 303-6777
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1467182774
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angela Childs — Owner/Provider · (623) 303-6777
NPI enumeratedJune 10, 2022
Last updated in NPPESMarch 19, 2023
Certification dateMarch 19, 2023
Mailing address12620 N Cave Creek Rd Ste 10a, Phoenix, AZ 85022-6528

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