Ambest Family Health Clinics, PLLC

Organization Active NPI Nurse Practitioner · Fort Mohave, AZ

NPI 1063068898 · NPPES record last updated Mar 13, 2020

Key facts

NPI
1063068898
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 363L00000X
Legal business name
AMBEST FAMILY HEALTH CLINICS, PLLC
Practice address
4841 S Mesa Villas Dr Apt 3
Fort Mohave, AZ 86426-6436
Phone
(928) 577-7368
Fax
(928) 299-3373
NPI assigned
Aug 16, 2019
Organization subpart
No

Authorized official

Name
Okey Iloegbunam, NP
Title
Owner / Member Manager
Phone
(770) 688-6691

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X Yes

Addresses

Primary practice location

4841 S Mesa Villas Dr Apt 3
Fort Mohave, AZ 86426-6436

Mailing address

4325 S Otis Rd
Fort Mohave, AZ 86426-6385
Phone (770) 688-6691

Other identifiers

IdentifierTypeStateIssuer
P22410618OtherAZCORPORATION ID
576901MedicaidAZ

Other providers in Fort Mohave, AZ

All providers in Fort Mohave, AZ · Nurse Practitioner in Arizona

Sources for this page

Verify at the official NPI Registry.