Individual provider Active NPI

Desire Alexis Collister, FNP

  • Family Nurse Practitioner
  • Casa Grande, AZ
National Provider Identifier
1669376265
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
260568 Issued in AZ
Practice address
1863 E Florence Blvd
Casa Grande, AZ 85122
Phone
(520) 836-3446
NPI assigned
Oct 6, 2026
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 260568 AZ Primary

Addresses

Primary practice location

1863 E Florence Blvd
Casa Grande, AZ 85122

Mailing address

240 S San Jose LN
Casa Grande, AZ 85194-7413

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1669376265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S SAN JOSE LN",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851947413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1863 E FLORENCE BLVD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85122",
            "telephone_number": "520-836-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLISTER",
        "first_name": "DESIRE",
        "middle_name": "ALEXIS",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "260568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.