Misty Maple, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP8774 Issued in AZ

Practice address

297 Lake Havasu Ave S Ste 204
Lake Havasu City, AZ 86403-6526

Phone

(928) 453-1970

NPI assigned

Jun 29, 2016

Last updated

Apr 16, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Arizona Emergency Medicine Specialists PC

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1134439706
  Medicare reassignment NPD
• Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1912053752

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1891146957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 VAGABOND DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864069230",
            "telephone_number": "928-680-0149",
            "fax_number": "928-680-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 LAKE HAVASU AVE S STE 204",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036526",
            "telephone_number": "928-453-1970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Civic Center Ln",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035607",
            "country_code": "US",
            "telephone_number": "928-486-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAPLE",
        "first_name": "MISTY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP8774",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Andrew Mahnke, ACNPC-AG
• Joseph Robert Majerus, DC
• Sherry Kaye Malm, MA LPC
• Peter M. Mamalakis, M.D.
• Manipulators Inc (American Chiropractic)
• Marc H. Zimmerman, M.D.P.C.
• Elmer Adrian Mares Morales, PHARMD
• Janet Marie Marinelli, PA-C
• Mark S Biliack MD PC
• Monica Marie Marks, M.S., ED.S.

• Family Nurse Practitioner in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.