Individual provider Active NPI

Letisha Driskell, FNP-BC

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1073499307
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
TEMP338183 Issued in AZ
Practice address
11240 N 19TH Ave Ste 23
Phoenix, AZ 85029-4825
Phone
(425) 243-3719
NPI assigned
Aug 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024194261 VA
Nurse Practitioner 363L00000X TEMP338183 AZ Primary

Addresses

Primary practice location

11240 N 19TH Ave Ste 23
Phoenix, AZ 85029-4825

Mailing address

7421 S 23Rd Dr
Phoenix, AZ 85041-5483

Other practice location 1

230 Browns Way Rd
Midlothian, VA 23114-9501
Phone (804) 419-9101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251019000186 VA Practitioner - Nurse Practitioner 0143718593 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment
Group practices
Clark Alliance Services IncGroup PAC ID 8325475981, 27 clinicians
Clark Palliative Medicine GroupGroup PAC ID 6901289461, 6 clinicians

Practice addresses (Care Compare)

2220 Edward Holland Dr
Richmond, VA 23230-2519
Phone (757) 276-5022

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 276-5020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Alliance Services Inc CurrentSince Sep 1, 2025 Accepting new patients
Midlothian Medi LLC Past Accepting new patients

Locations

2220 Edward Holland Dr
Richmond, VA 23230
Phone (804) 678-7000

3575 Bridge Rd
Ste 8
Suffolk, VA 23435
Phone (757) 632-7107

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1073499307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 S 23RD DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11240 N 19TH AVE STE 23",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294825",
            "telephone_number": "425-243-3719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Browns Way Rd",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231149501",
            "country_code": "US",
            "telephone_number": "804-419-9101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRISKELL",
        "first_name": "LETISHA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024194261",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "TEMP338183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.