# VIRTUALMED PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Virtual Med
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104609932
- **Authorized official:** DR. MIANNA GALE PMHNP-BC (OWNER)
- **Authorized official phone:** (480) 603-8859

## Contact information

- **Practice address:** 4140 E BASELINE RD STE 101, MESA, AZ 85206-4413
- **Practice address phone:** (480) 603-8859
- **Mailing address:** PO BOX 51504, MESA, AZ 85208-0076
- **Mailing address phone:** (480) 603-8859

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 08/15/2023
- **Last updated:** 09/17/2024