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Organization
ARK COVERNANT
Active
Organization
ARK COVERNANT
Active
Other names
Telehealth - Psychiatric Nurse Practitioner, Ark Covernant LLC (Behavioral Residential Home)
Organization subpart
No
Provider details
NPI number
Authorized official
NGWI RITA ETIENDEM DNP, PMHNP-BC (NURSE PRACTITIONER)
(480) 667-8101
Entity
Organization
Contact information
Practice address
20987 N JOHN WAYNE PKWY, MARICOPA, AZ 85139-2926
(480) 667-8101
Mailing address
44202 W GRANITE DR, MARICOPA, AZ 85139-8868
(480) 667-8101
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
873312201
—
AZ
Enumeration date
01/03/2023
Last updated
09/30/2026
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