Individual
AMANDA SIMMONS GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 263-1619
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 581-6076
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
33644
AZ
207Q00000X
Family Medicine Physician
33644
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
989759
—
AZ
01
—
P00477582
RR MEDICARE
AZ
Enumeration date
06/28/2006
Last updated
11/13/2025
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