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Dr. Samuel W Fongang
Family Nurse Practitioner in Camp Verde, Arizona
NPI 1477211076

Samuel W Fongang is a Family Nurse Practitioner based in Provo, AZ and is specialized in Family. Samuel W Fongang practices in Camp Verde, AZ. The NPI Number for Samuel W Fongang is 1477211076 and holds a License No. 65969 (Arizona).

The current practice location address for Samuel W Fongang is 1298 W Finnie Flat Rd, Camp Verde, AZ and can be reached out via phone at 928-639-5555.

Location: 1298 W Finnie Flat Rd, Camp Verde, AZ, 84606-5644
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477211076
Provider Name
Samuel W Fongang
Credential
Provider Entity Type
Individual
Gender
Male
Address
1298 W Finnie Flat Rd, Camp Verde, AZ, 84606-5644
Phone Number
928-639-5555
Fax Number
Provider Enumeration Date
12/01/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1298 W Finnie Flat Rd
City
Camp Verde
State
Arizona
Zip
86322-5958
Phone Number
928-639-5555
Fax Number
person
Provider Business Mailing Address Details
Address
1298 W Finnie Flat Rd
City
Camp Verde
State
Arizona
Zip
86322-5958
Phone Number
928-639-5555
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
65969 (New Mexico)
Definition
Definition to come...
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