Provider Demographics
NPI:1053923599
Name:MONYENYE, NANCY OGOTI (PMHNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:OGOTI
Last Name:MONYENYE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 E INDIAN WELLS PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-4166
Mailing Address - Country:US
Mailing Address - Phone:214-778-9471
Mailing Address - Fax:
Practice Address - Street 1:2518 E INDIAN WELLS PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-4166
Practice Address - Country:US
Practice Address - Phone:214-778-9471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ000000000000000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health