Healthcare Provider Details

I. General information

NPI: 1144167826
Provider Name (Legal Business Name): UGOCHINYEREM N MONEKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6913 W GREENBRIAR DR
GLENDALE AZ
85308-8446
US

IV. Provider business mailing address

6913 W GREENBRIAR DR
GLENDALE AZ
85308-8446
US

V. Phone/Fax

Practice location:
  • Phone: 602-628-7625
  • Fax:
Mailing address:
  • Phone: 602-628-7625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number338135
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: