Provider Demographics
NPI:1366930794
Name:FAUCETT, JOYCE MARIE (FNP)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIE
Last Name:FAUCETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 W HAZELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-2648
Mailing Address - Country:US
Mailing Address - Phone:520-403-3497
Mailing Address - Fax:602-235-0296
Practice Address - Street 1:5620 W THUNDERBIRD RD STE B3
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4638
Practice Address - Country:US
Practice Address - Phone:602-206-6262
Practice Address - Fax:602-235-0296
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP11192207RS0012X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ435003Medicaid