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NPI Code Detail

MEDICARE: NP PSYCH AND MENTAL HEALTH PLLC

MEDICARE: NP PSYCH AND MENTAL HEALTH PLLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1952075590
Entity Type Code : Organization
Provider Name (Legal Business Name) : NP PSYCH AND MENTAL HEALTH PLLC
Provider Business Mailing Address
First Line : 3707 E SOUTHERN AVE STE 501
Second Line :
City : MESA
State : AZ
Zip : 85206-2569
Country : US
Telephone Number : 602-661-7550
Fax Number : 602-661-7554
Provider Business Practice Location Address
First Line : 6300 RIVERSIDE PLAZA LN NW STE 100
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1908
Country : US
Telephone Number : 505-456-0400
Fax Number : 833-913-2523
Authorized Official
Title or Position : OWNER/PROVIDER
Name : KEIRA STEVENS
Credential : PMHNP-BC
Telephone Number : 602-661-7550
Provider Enumeration Date : 08/06/2021
Last Update Date : 12/23/2025

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