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) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | |||
| Nurse Practitioner |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P22410618 | Other | AZ | CORPORATION ID |
| 576901 | Medicaid | AZ |
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- Arizona CVS Stores, L.L.C.
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All providers in Fort Mohave, AZ · Nurse Practitioner in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.