Healthcare Provider Details

I. General information

NPI: 1104779362
Provider Name (Legal Business Name): PATRICIA NUNEZ PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WASHINGTON AVE S
MINNEAPOLIS MN
55401-2110
US

IV. Provider business mailing address

100 WASHINGTON AVE S
MINNEAPOLIS MN
55401-2110
US

V. Phone/Fax

Practice location:
  • Phone: 956-949-1949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1183105
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: