Healthcare Provider Details
I. General information
NPI: 1952245938
Provider Name (Legal Business Name): GHV MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21035 N CAVE CREEK RD # 5C
PHOENIX AZ
85024-5522
US
IV. Provider business mailing address
21035 N CAVE CREEK RD # 5C
PHOENIX AZ
85024-5522
US
V. Phone/Fax
- Phone: 602-402-8048
- Fax: 602-699-4197
- Phone: 602-402-8048
- Fax: 602-699-4197
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARISSA
YVONNE
BOWEN
Title or Position: OWNER/FAMILY NURSE PRACTITIONER
Credential: FNP-C
Phone: 602-402-8048