Provider Demographics
NPI:1871075705
Name:HOUCHENS, ELIZABETH JOYCE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JOYCE
Last Name:HOUCHENS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8447 E KEATS AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-4358
Mailing Address - Country:US
Mailing Address - Phone:623-341-2426
Mailing Address - Fax:
Practice Address - Street 1:1750 E BROADWAY RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-1612
Practice Address - Country:US
Practice Address - Phone:480-557-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ218029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty