MEDICARE: MINDCARE PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1922867639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDCARE PSYCHIATRY

Provider Business Mailing Address
First Line	:	3819 STERLING CREST PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-7838
Country	:	US
Telephone Number	:	949-287-1657
Fax Number	:

Provider Business Practice Location Address
First Line	:	3819 STERLING CREST PL
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-7838
Country	:	US
Telephone Number	:	949-287-1657
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LINDSAY VICTORIA FISHER
Credential	:	APRN, PMHNP-BC
Telephone Number	:	949-287-1657

Provider Enumeration Date	:	03/15/2024
Last Update Date	:	03/15/2024

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