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General NPI Number Information
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NPI Number | 1619805256
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Entity Type | Organization
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Legal Business Name | LIFESPAN PSYCHIATRY
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 4539 N 22ND ST STE N
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 602-610-4224
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Fax | 888-444-3116
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Provider Business Mailing Address
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Address Line | 4539 N 22ND ST STE N
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | PATRICIA OGUDE
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Credential |
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Telephone | 404-468-4777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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