Princess Gehyigon-Wallace

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6598 Issued in MN

Practice address

7362 University Ave NE Ste 310-3
Fridley, MN 55432-3142

Phone

(612) 567-9587

Fax

(763) 201-3093

NPI assigned

May 28, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Princess Gehyigon Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Balanzen Mental Health Corp.

  • Clinic/Center
  • Apple Valley, MN
  • NPI 1437923117
  Medicare reassignment NPD Authorized official
• Martha's Open Hands PLLC

  • Clinic/Center
  • Fridley, MN
  • NPI 1235857673
  Medicare reassignment NPD Authorized official
• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  Medicare reassignment NPD
• Premiere Mental Health LLC

  • Clinic/Center
  • Saint Paul, MN
  • NPI 1023832938
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1275190027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7362 UNIVERSITY AVE NE # 310-3",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323142",
            "telephone_number": "651-628-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7362 UNIVERSITY AVE NE STE 310-3",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323142",
            "telephone_number": "612-567-9587",
            "fax_number": "763-201-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEHYIGON-WALLACE",
        "first_name": "PRINCESS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRINCESS",
            "last_name": "GEHYIGON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eric Keith Garnett, LADC
• Drew Gaurke, PA-C
• Asiya Abdulkadir Gazali
• Jennifer Sorman Gednalske, PHARM. D.
• Marcus Geffre
• Farhiya Mahamud Gelle I
• Dereje M Gemeda
• Sarah Elaine Gibson
• Tricia K. Gibson, M.A., LMFT
• Nathan Paul Gille, OPA-C

• Psychiatric/Mental Health Nurse Practitioner in Fridley, MN
• Providers in Fridley, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.