Healthcare Provider Details

I. General information

NPI: 1124786702
Provider Name (Legal Business Name): PATRICE NOEL AUGUSTYNIAK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICE NOEL BARKER

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14506 W GRANITE VALLEY DR STE 102
SUN CITY WEST AZ
85375-6011
US

IV. Provider business mailing address

14506 W GRANITE VALLEY DR STE 102
SUN CITY WEST AZ
85375-6011
US

V. Phone/Fax

Practice location:
  • Phone: 623-232-8129
  • Fax: 623-321-1293
Mailing address:
  • Phone: 623-232-8129
  • Fax: 623-321-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number261536
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: