Provider Demographics
NPI:1952397804
Name:FAUCON, ARLENE BERIT (NP)
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:BERIT
Last Name:FAUCON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3960 E RIGGS RD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5411
Mailing Address - Country:US
Mailing Address - Phone:480-786-4441
Mailing Address - Fax:480-786-4609
Practice Address - Street 1:3960 E RIGGS RD
Practice Address - Street 2:#1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5411
Practice Address - Country:US
Practice Address - Phone:480-786-4441
Practice Address - Fax:480-786-4609
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN054751163W00000X
AZAP0274363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ153487Medicaid
AZZ153487Medicare UPIN
AZZ153487Medicare PIN