Individual
WITEH BOSAMBE ESOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4921 E BELL RD STE 205, SCOTTSDALE, AZ 85254-6002
(800) 640-3451
Mailing address
PO BOX 1200, PLEASANT GROVE, UT 84062-1200
(800) 640-3451
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-232548-2
MN
363LP2300X
Primary Care Nurse Practitioner
Primary
260162
AZ
Other
Enumeration date
09/13/2016
Last updated
05/20/2025
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