Provider Demographics
NPI:1124786702
Name:AUGUSTYNIAK, PATRICE NOEL (FNP)
Entity type:Individual
Prefix:
First Name:PATRICE
Middle Name:NOEL
Last Name:AUGUSTYNIAK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:NOEL
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:261 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2617
Mailing Address - Country:US
Mailing Address - Phone:480-677-8282
Mailing Address - Fax:888-316-1686
Practice Address - Street 1:16329 W. CACTUS RD. #100
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388
Practice Address - Country:US
Practice Address - Phone:480-677-8282
Practice Address - Fax:888-316-1686
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ261536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ107795Medicaid