Provider Demographics
NPI:1346617594
Name:AKHIMIEN, PATIENCE RONKE (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:PATIENCE
Middle Name:RONKE
Last Name:AKHIMIEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16336 W MORELAND ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-6291
Mailing Address - Country:US
Mailing Address - Phone:623-213-7135
Mailing Address - Fax:623-213-8162
Practice Address - Street 1:13350 N 94TH DR STE B102
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4826
Practice Address - Country:US
Practice Address - Phone:623-213-7135
Practice Address - Fax:623-213-8162
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002442363L00000X, 363LF0000X, 363LP0808X
AZ218226363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ533103Medicaid
CAE1243713OtherDMC-CALIFORNIA