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General NPI Number Information
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NPI Number | 1457963605
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Entity Type | Individual
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Provider Name | ALEX PATRICK BAKOWSKI FNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 2910 N 3RD AVE # 200
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City | PHOENIX
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State | AZ
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Zip | 85013-4434
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Country | US
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Telephone | 602-406-6775
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Fax | 602-406-6398
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Provider Business Mailing Address
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Address Line | 1323 E WESTCHESTER DR
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City | TEMPE
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State | AZ
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Zip | 85283-3150
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Country | US
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Telephone | 708-533-2484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 245760
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License Number State | AZ
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