Provider Demographics
NPI:1235384462
Name:GONYEA, MARCIA J (RN)
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:J
Last Name:GONYEA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MARCIA
Other - Middle Name:J
Other - Last Name:NULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3003 N CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2902
Mailing Address - Country:US
Mailing Address - Phone:602-952-3400
Mailing Address - Fax:602-952-3401
Practice Address - Street 1:5030 W MCDOWELL RD
Practice Address - Street 2:SUITE 16
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-3945
Practice Address - Country:US
Practice Address - Phone:602-278-1414
Practice Address - Fax:602-269-8410
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN055515163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health