Individual
VINCENT P EKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
18628 N 43RD ST, PHOENIX, AZ 85050-3342
(602) 489-9606
Mailing address
18628 N 43RD ST, PHOENIX, AZ 85050-3342
(602) 489-9606
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
242271
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081286
—
AZ
Enumeration date
06/19/2020
Last updated
03/18/2024
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