Organization
WISEMIND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN DINGELDEIN PMHNP, BC (PSYCHIATRIC NURSE PRACTITIONER)
(541) 990-2613
Entity
Organization
Contact information
Practice address
20 E THOMAS RD STE 2200, PHOENIX, AZ 85012-3133
(541) 990-2613
Mailing address
P.O. BOX 33784, PHOENIX, AZ 85067-3784
(480) 359-5816
(833) 520-1481
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
632705
—
AZ
Enumeration date
02/12/2021
Last updated
04/05/2021
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