Healthcare Provider Details

I. General information

NPI: 1154718328
Provider Name (Legal Business Name): CHIDINMA FAITH ACHEAMPONG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6611 W PEORIA AVE STE 13
GLENDALE AZ
85302-7020
US

IV. Provider business mailing address

6611 W PEORIA AVE STE 13
GLENDALE AZ
85302-7020
US

V. Phone/Fax

Practice location:
  • Phone: 888-405-6396
  • Fax: 415-252-7176
Mailing address:
  • Phone: 888-405-6396
  • Fax: 415-252-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP7674
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: