Grace Chidinma Ezenwaka, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Tucson, AZ
NPI 1023906997 · NPPES record last updated Aug 18, 2025
Key facts
- NPI
- 1023906997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 262215 (AZ)
- Practice address
- 250 S Toole Ave Ste B
Tucson, AZ 85701-1814 - Phone
- (520) 617-5500
- NPI assigned
- Jun 27, 2025
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Community Bridges Inc
Practice addresses (Care Compare)
250 S Toole Ave
Suite B
Tucson, AZ 85701-1814
Phone (520) 323-1312
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251015000839 | AZ | Practitioner - Nurse Practitioner | 4082101852 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 262215 | AZ | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icare Health Services LLC | Current |
Accepting new patients | |
| Community Bridges, Inc | Current | Accepting new patients | |
| Desert Bolt Behavioral LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Community Bridges, Inc. | Current | Accepting new patients | |
| Community Bridges, Inc. | Current | Accepting new patients | |
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Community Bridges, Inc. | Current |
Accepting new patients | |
| Community Bridges, Inc. | Past |
Accepting new patients | |
| Community Bridges, Inc. | Past | Accepting new patients | |
| Icare Health Services LLC | Past |
Accepting new patients | |
| Community Bridges, Inc. | Past |
Accepting new patients |
Locations
42201 N 41st Dr
Ste B160
Anthem, AZ 85086
Phone (480) 527-0042
824 N 99th Ave
Ste 107108
Avondale, AZ 85323
Phone (623) 907-1457
675 E Cottonwood Ln
Ste 140
Casa Grande, AZ 85122
Phone (520) 426-0088
5222 W Glendale Ave
Glendale, AZ 85301
Phone (623) 303-3813
560 S Bellview
Rm A
Mesa, AZ 85204
Phone (480) 962-7711
358 E Javelina Ave
Ste 101
Mesa, AZ 85210
Phone (480) 507-3180
1855 W Baseline Rd
Ste 101
Mesa, AZ 85202
2770 E Van Buren St
Rm A
Phoenix, AZ 85008
Phone (602) 273-9999
2770 E Van Buren St
Rm Abd
Phoenix, AZ 85008
Phone (602) 273-9999
2770 E Van Buren St
Ste Abd
Phoenix, AZ 85008
250 S Toole Ave
Ste A
Tucson, AZ 85701
Phone (520) 323-1312
250 S Toole Ave
Ste B
Tucson, AZ 85701
Phone (520) 323-1312
3180 E 40th St
Yuma, AZ 85365
Phone (928) 341-0335
Interoperability endpoints
- grace.ezenwakarn.p1@direct.cbridges.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 262215 | AZ | Yes |
Addresses
Primary practice location
250 S Toole Ave Ste B
Tucson, AZ 85701-1814
Mailing address
6311 W Magdalena LN
Laveen, AZ 85339-5483
Phone (480) 749-9098
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Information | Health Information Exchange (HIE) |
Other providers in Tucson, AZ
- Thomas Eyler
- Heidi Sarah Rhiannon Eyre
- Jacqulyn Marie Eyrich
- Adaora Ezeani
- Chioma Kenechukwu Ezekwe
- F.C. of Arizona, Inc.
- Kimberly Mikell Faber
- Tatum Faber
- Jill Fabian
- James Eliot Fabricant
All providers in Tucson, AZ · Psychiatric/Mental Health Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.