Mindful Moments Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MINDFUL MOMENTS PSYCHIATRY, LLC

Practice address

270 W Georgia Ave Ste 107
Nampa, ID 83686-2835

Phone

(509) 703-0736

NPI assigned

Jul 18, 2024

Organization subpart

No

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

Authorized official

Name

Kerrie Petech, PMHNP-BCNPI 1265414544

Title

Owner/Prescriber

Phone

(509) 703-0736

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kerrie L Petech, R.N. ARNP-CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Meridian, ID
  • NPI 1265414544
  NPD Authorized official

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1942048368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 N HORTON ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836511936",
            "telephone_number": "509-703-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 W GEORGIA AVE STE 107",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862835",
            "telephone_number": "509-703-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MOMENTS PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "PETECH",
        "authorized_official_first_name": "KERRIE",
        "authorized_official_title_or_position": "OWNER/PRESCRIBER",
        "authorized_official_telephone_number": "509-703-0736",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Holdcroft Millward, MD
• Jennifer Jean Mimish, CNM, WHNP
• Brian Ora Minasian, PHARM D
• Mind Life Wellbeing Inc
• Mindful Healing Psychiatry of Idaho
• Mindhaven Mental Health
• Gracie Ann Mingo
• Ashton Miranda
• Sydney Miraz, DPT
• Leo Mironovich

• Psychiatric/Mental Health Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.