Healthcare Provider Details

I. General information

NPI: 1265714976
Provider Name (Legal Business Name): VICTORIA C. BOCAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 E MOUNTAIN VIEW RD #220
SCOTTSDALE AZ
85258-5199
US

IV. Provider business mailing address

9201 E MOUNTAIN VIEW RD #220
SCOTTSDALE AZ
85258-5199
US

V. Phone/Fax

Practice location:
  • Phone: 480-862-1700
  • Fax: 480-907-2108
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN223893L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP011117
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: