Individual
CAROLINE WACEKE MIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11361 N 99TH AVE STE 200, PEORIA, AZ 85345-5470
(602) 650-1212
Mailing address
2701 N 16TH ST STE 316, PHOENIX, AZ 85006-1266
(602) 636-3085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN162403
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
223230
AZ
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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