Healthcare Provider Details

I. General information

NPI: 1801503008
Provider Name (Legal Business Name): LINDA M MEKANG DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 E DISTRICT ST
TUCSON AZ
85714-2081
US

IV. Provider business mailing address

9550 S VIA BANDERA
VAIL AZ
85641-2167
US

V. Phone/Fax

Practice location:
  • Phone: 240-688-5720
  • Fax:
Mailing address:
  • Phone: 240-688-5720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number246918
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: