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General NPI Number Information
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NPI Number | 1033016308
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Entity Type | Organization
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Legal Business Name | SHIFTED MIND PSYCHIATRIC CARE
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Dates
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Enumeration Date | 10/21/2026
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Last Update Date | 10/21/2026
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Provider Practice Location Address
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Address Line | 15150 W PK PL STE 215
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City | GOODYEAR
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State | AZ
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Zip | 85395
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Country | US
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Telephone | 480-901-4227
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Fax |
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Provider Business Mailing Address
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Address Line | 2235 E JENSEN ST
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City | MESA
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State | AZ
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Zip | 85213-3438
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Country | US
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Telephone | 480-901-4227
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MELISSA ANNE NELSON
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Credential | APRN, PMHNP-BC
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Telephone | 480-901-4227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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