Christiana Archibong

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Tempe, AZ

NPI 1093364622 · NPPES record last updated Sep 11, 2026

Key facts

NPI
1093364622
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
239526 (AZ)
Practice address
1500 N Priest Dr Ste 109
Tempe, AZ 85288-1213
Phone
(702) 589-4871
Fax
(702) 589-4872
NPI assigned
Sep 6, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

21168 E Ocotillo Rd
Queen Creek, AZ 85142-8175

2200 Paseo Verde Pkwy
Suite 190
Henderson, NV 89052-2701

312 Arizona Ave
Suite 31
Santa Monica, CA 90401-1306

890 W Elliot Rd
Gilbert, AZ 85233-5102
Phone (407) 476-5568

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251006003062 AZ Practitioner - Nurse Practitioner 7719310457 Reassigns benefits to 2 organizations
Practice locations: Gilbert, AZ

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-78718-041KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Channels of Healing Med Clinic & Spa LLC Family Current
since Jul 21, 2025
Accepting new patients

Locations

890 W Elliot Rd
Gilbert, AZ 85233
Phone (480) 500-2285

21168 E Ocotillo Rd
San Tan Vly, AZ 85142
Phone (520) 677-8025

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-78718-041 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 239526 AZ Yes
Family Nurse Practitioner 363LF0000X 239526 AZ

Addresses

Primary practice location

1500 N Priest Dr Ste 109
Tempe, AZ 85288-1213

Mailing address

1500 N Priest Dr Ste 109
Tempe, AZ 85288-1213
Phone (702) 589-4871

Other practice location 1

21508 W 51st Pl
Shawnee, KS 66226-9731
Phone (913) 486-2906

Other providers in Tempe, AZ

All providers in Tempe, AZ · Psychiatric/Mental Health Nurse Practitioner in Arizona

Sources for this page

Verify at the official NPI Registry.