Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stephanie Rae Park, ACNP-BC

Individual provider Nurse Practitioner · NPI 1750621793

Stephanie Rae Park, ACNP-BC is a Nurse Practitioner in Scottsdale, Arizona. Qualified in 2012, 14 years ago. Practices with Mayo Clinic Arizona, a 1,616-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
14
Licensed in
AZ
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

13400 E Shea Blvd
Scottsdale, AZ 85259
Phone: (480) 301-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence AP4883 (AZ)
Nurse Practitioner Taxonomy 363L00000X · Licence RN156020 (AZ)

Record details

NPI number1750621793
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNP-BC
Sole proprietorNo
NPI enumeratedFebruary 28, 2013
Last updated in NPPESSeptember 3, 2020
Certification dateSeptember 3, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Mayo Clinic Arizona — 1616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Scottsdale