Provider Demographics
NPI:1336763218
Name:NKENDONG, VALERY AYAFOR (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:VALERY
Middle Name:AYAFOR
Last Name:NKENDONG
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42201 N 41ST DR STE 160
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3803
Mailing Address - Country:US
Mailing Address - Phone:480-527-0042
Mailing Address - Fax:
Practice Address - Street 1:42201 N 41ST DR STE 160
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3803
Practice Address - Country:US
Practice Address - Phone:480-527-0042
Practice Address - Fax:480-499-5921
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ241989363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health