Individual provider · Type 1 NPI
Jesse Headapohl Fatoma
Psychiatric/Mental Health Nurse Practitioner · Avondale, AZ
NPI number
1407743891
Active
Practice location
11770 W Davis Ln
Avondale, AZ 85323-7695
Other practice locations
- 11770 W Davis Ln, Avondale, AZ 85323-7695 · (480) 217-8964
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 326908 (AZ) |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN204116 (AZ) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
Other psychiatric/mental health nurse practitioner providers in Avondale
- Kathleen Marie Decker, NPPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1013845205
- Ijeoma J. IgbokwePsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1023925179
- Bolatito Oyeronke Okougbo, NPPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1063095503
- Asha-Lee Cadogan, NURSE PRACTITIONERPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1124682653
- Malcolm Garvey Duncan Sr., APRNPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1174382121
- Mosunmoluwa Adesanya, APRNPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1205458429
- Rose Lopez, NPPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1235975400
- Michelle Iliescu, DNP, PMHNP-BCPsychiatric/Mental Health Nurse Practitioner Avondale, AZ NPI 1245924653
About NPI 1407743891
Jesse Headapohl Fatoma's National Provider Identifier is 1407743891, issued on Jun 19, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Avondale, AZ. The record was last updated on Jun 5, 2026.