Individual provider Active NPI

Elena Darlene Pack

  • Registered Nurse
  • Gilbert, AZ
National Provider Identifier
1063355030
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN083774 Issued in AZ
Practice address
500 S McQueen Rd
Gilbert, AZ 85233-6506
Phone
(480) 632-4750
NPI assigned
Apr 13, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN083774 AZ Primary

Addresses

Primary practice location

500 S McQueen Rd
Gilbert, AZ 85233-6506

Mailing address

19364 E Thornton Rd
Queen Creek, AZ 85142-8575
Phone (480) 577-6064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN083774AZMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1063355030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19364 E THORNTON RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428575",
            "telephone_number": "480-577-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MCQUEEN RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852336506",
            "telephone_number": "480-632-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "ELENA",
        "middle_name": "DARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN083774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.