Provider Demographics
NPI:1225417561
Name:BOTCHEY-NIIQUAYE, JOYCE (FNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:BOTCHEY-NIIQUAYE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9101
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-9494
Mailing Address - Country:US
Mailing Address - Phone:972-745-7500
Mailing Address - Fax:972-956-8887
Practice Address - Street 1:1661 EASTCHASE PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-4407
Practice Address - Country:US
Practice Address - Phone:817-459-2005
Practice Address - Fax:817-459-3797
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127797363LF0000X
TX874505163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse