Provider Demographics
NPI:1215379359
Name:FACEY, NGOZI NATASHA (ARNP-BC)
Entity type:Individual
Prefix:MRS
First Name:NGOZI
Middle Name:NATASHA
Last Name:FACEY
Suffix:
Gender:F
Credentials:ARNP-BC
Other - Prefix:MRS
Other - First Name:NGOZI
Other - Middle Name:
Other - Last Name:ANENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:7215 E SILVERSTONE DR APT 3005
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4968
Mailing Address - Country:US
Mailing Address - Phone:786-712-8706
Mailing Address - Fax:
Practice Address - Street 1:7215 E SILVERSTONE DR APT 3005
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4968
Practice Address - Country:US
Practice Address - Phone:786-712-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10493363L00000X
FL9240436363L00000X
FLARNP9240436363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009984000Medicaid
FLHO987ZOtherMEDICARE PTAN
FLHO987ZMedicare PIN