Healthcare Provider Details

I. General information

NPI: 1215682984
Provider Name (Legal Business Name): GRACE AKECH OPIYO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5981 E GRANT RD STE 109
TUCSON AZ
85712-2363
US

IV. Provider business mailing address

3333 E CAMELBACK RD STE 180
PHOENIX AZ
85018-2396
US

V. Phone/Fax

Practice location:
  • Phone: 520-290-5260
  • Fax: 520-290-5284
Mailing address:
  • Phone: 602-759-6883
  • Fax: 602-224-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number271086
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number271086
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: