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General NPI Number Information
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NPI Number | 1710695325
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Entity Type | Individual
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Provider Name | ALEXANDRIA BOSAK
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Gender | Female
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Dates
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Enumeration Date | 11/11/2022
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 965 W CHANDLER HEIGHTS RD
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City | CHANDLER
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State | AZ
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Zip | 85248-5724
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Country | US
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Telephone | 480-460-4949
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Fax | 480-460-5858
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Provider Business Mailing Address
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Address Line | 6285 S HIGLEY RD
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City | GILBERT
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State | AZ
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Zip | 85298-4262
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Country | US
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Telephone | 480-460-4949
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Fax | 480-460-5858
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | RN205985
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 289060
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License Number State | AZ
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