Provider Demographics
NPI:1578222451
Name:BOCI, ANDIA ALEXIS (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:ANDIA
Middle Name:ALEXIS
Last Name:BOCI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E THOMAS RD STE 215
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3109
Mailing Address - Country:US
Mailing Address - Phone:480-399-8455
Mailing Address - Fax:
Practice Address - Street 1:77 E THOMAS RD STE 215
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3109
Practice Address - Country:US
Practice Address - Phone:480-399-8455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-08
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ267548363LP0808X
AZRN198300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health