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Individual
UCHE IKE
Active
Individual
UCHE IKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1026507
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202113376NP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
256479
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95019944
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155795
—
AZ
Enumeration date
02/12/2021
Last updated
11/01/2022
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