Provider Demographics
NPI:1134718059
Name:PEACE OF NATURE PSYCHIATRY, P.C.
Entity type:Organization
Organization Name:PEACE OF NATURE PSYCHIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PMHNP
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BOSSE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC
Authorized Official - Phone:928-331-0070
Mailing Address - Street 1:7760 E STATE ROUTE 69 STE C5-359
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-2201
Mailing Address - Country:US
Mailing Address - Phone:928-331-0070
Mailing Address - Fax:
Practice Address - Street 1:4155 N VAL VERDE WAY
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-5462
Practice Address - Country:US
Practice Address - Phone:928-331-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty