Basic Information
| Provider Information | |||||||||
| NPI: | 1225417561 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOTCHEY-NIIQUAYE | ||||||||
| FirstName: | JOYCE | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9101 | ||||||||
| Address2: | |||||||||
| City: | COPPELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750199494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727457500 | ||||||||
| FaxNumber: | 9729568887 | ||||||||
| Practice Location | |||||||||
| Address1: | 1661 EASTCHASE PKWY | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761204407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174592005 | ||||||||
| FaxNumber: | 8174593797 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2015 | ||||||||
| LastUpdateDate: | 03/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP127797 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 874505 | TX | N | Nursing Service Providers | Registered Nurse |
No ID Information.