Healthcare Provider Details

I. General information

NPI: 1477103455
Provider Name (Legal Business Name): GRAHAM C. SAWICKI DNP, FNP-BC, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 S DOBSON RD STE 402
MESA AZ
85202-4777
US

IV. Provider business mailing address

1432 S DOBSON RD STE 402
MESA AZ
85202-4777
US

V. Phone/Fax

Practice location:
  • Phone: 480-412-5550
  • Fax: 480-412-5434
Mailing address:
  • Phone: 480-412-5550
  • Fax: 480-412-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN174629
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRNP232092
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: