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General NPI Number Information
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NPI Number | 1215334172
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Entity Type | Individual
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Provider Name | MEDINA MAKENA KAMAU PMHNP
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Gender | Female
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 9051 W KELTON LN STE 13
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City | PEORIA
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State | AZ
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Zip | 85382-3533
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Country | US
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Telephone | 623-815-5700
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Fax | 623-815-5759
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Provider Business Mailing Address
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Address Line | 2700 N CENTRAL AVE STE 1050
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City | PHOENIX
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State | AZ
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Zip | 85004-1217
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Country | US
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Telephone | 602-266-8402
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Fax | 602-264-0887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP7446
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License Number State | AZ
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