Individual provider Active NPI

Kerubo Happiness Nyachieo, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1891657516
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
266475 Issued in AZ
Practice address
4015 W Salter Dr
Glendale, AZ 85308-2078
Phone
(410) 660-5117
NPI assigned
Dec 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 266475 AZ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1226902 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95040638 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP.70134409 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10057912 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AC009208 MD

Addresses

Primary practice location

4015 W Salter Dr
Glendale, AZ 85308-2078

Mailing address

4015 W Salter Dr
Glendale, AZ 85308-2078
Phone (410) 660-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4015 W Salter Dr
Glendale, AZ 85308-2078

4360 Beltway PL
Suite 280
Arlington, TX 76018-1043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TEMP266475AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Borabora Integrated Health System Current Accepting new patients
Beka'S Comfort Home Current Accepting new patients
Valley Healthcare Current Accepting new patients
Shamlock Nursing Services LLC Psychiatric/Mental Health Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1891657516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 W SALTER DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853082078",
            "telephone_number": "410-660-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 W SALTER DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853082078",
            "telephone_number": "410-660-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYACHIEO",
        "first_name": "KERUBO",
        "middle_name": "HAPPINESS",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "266475",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1226902",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95040638",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP.70134409",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10057912",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC009208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.