Provider Demographics
NPI:1023229507
Name:DOENCH, EILEEN L (FNP-C)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:L
Last Name:DOENCH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:L
Other - Last Name:RIEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:10420 N NICKLAUS DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-5717
Mailing Address - Country:US
Mailing Address - Phone:602-349-0611
Mailing Address - Fax:
Practice Address - Street 1:10420 N NICKLAUS DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-5717
Practice Address - Country:US
Practice Address - Phone:602-349-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN093989363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ424888OtherAHCCESS
AZ553009Medicare UPIN