Individual
MS. BOSE GRACE ANIFOWOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP, PMHNP
Contact information
Practice address
1075 W AVALON CANYON DR, CASA GRANDE, AZ 85122-6706
(623) 565-2668
(520) 635-5510
Mailing address
2381 E ALONSO DR, CASA GRANDE, AZ 85194-7460
(623) 565-2668
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP7746
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP7746
AZ
Other
Enumeration date
06/01/2015
Last updated
02/03/2024
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