Peoria Mind and Wellness PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PEORIA MIND AND WELLNESS PLLC

Practice address

9196 W Mine TRL
Peoria, AZ 85383-5129

Phone

(602) 820-4104

NPI assigned

Apr 12, 2022

Organization subpart

No

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

Authorized official

Name

Caroline Miya, OWNER

Title

NP

Phone

(602) 820-4104

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1407598063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9196 W MINE TRL",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9196 W MINE TRL",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835129",
            "telephone_number": "602-820-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA MIND AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "MIYA",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "602-820-4104",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.