Provider Demographics
NPI:1316420631
Name:OGARI, ERIC MOSOKOBE (FNP)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MOSOKOBE
Last Name:OGARI
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:EUPHRASE
Other - Middle Name:MOSOKOBE
Other - Last Name:NYOKWOYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15550 W RIO VISTA LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9441
Mailing Address - Country:US
Mailing Address - Phone:760-521-2388
Mailing Address - Fax:
Practice Address - Street 1:16430 W YUMA RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-3102
Practice Address - Country:US
Practice Address - Phone:623-465-6405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily