Active NPI
Myra F Nkule
- Primary Care Nurse Practitioner
- Winslow, AZ
National Provider Identifier
1700412350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 238661
- Practice address
- 2100 S Highway 87
Winslow, AZ 86047-9789 - Phone
- (928) 289-9551
- NPI assigned
- Mar 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 238661 | AZ | Primary |
Addresses
Primary practice location
2100 S Highway 87
Winslow, AZ 86047-9789
Mailing address
1609 56TH St
Lubbock, TX 79412-2803
Phone (806) 317-8533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238661 | AZ | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584316800000",
"number": "1700412350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1609 56TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794122803",
"telephone_number": "806-317-8533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 S HIGHWAY 87",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860479789",
"telephone_number": "928-289-9551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NKULE",
"first_name": "MYRA",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-16",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "AZ",
"license": "238661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winslow, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.