Individual
GRACE CHIDINMA EZENWAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
250 S TOOLE AVE STE B, TUCSON, AZ 85701-1814
(520) 617-5500
Mailing address
6311 W MAGDALENA LN, LAVEEN, AZ 85339-5483
(480) 749-9098
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
262215
AZ
Other
Enumeration date
06/27/2025
Last updated
08/18/2025
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