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General NPI Number Information
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NPI Number | 1275214439
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Entity Type | Organization
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Legal Business Name | GENESIS OF PEACE INTEGRATED HEALTH
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 3530 S VAL VISTA DR STE A111
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City | GILBERT
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State | AZ
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Zip | 85297-7319
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Country | US
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Telephone | 480-936-3995
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Fax | 210-761-3858
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Provider Business Mailing Address
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Address Line | 2278 E ASTER DR
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City | CHANDLER
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State | AZ
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Zip | 85286-2353
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Country | US
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Telephone | 480-953-3995
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | DR. AKOSUA ANKAMAH MENSAH
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Credential | DNP, FNP-C
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Telephone | 480-953-3995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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