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General NPI Number Information
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NPI Number | 1295385052
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Entity Type | Organization
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Legal Business Name | AWAQEN PSYCHIATRY PLLC
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 340 FALCON RIDGE PKWY STE 603
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City | MESQUITE
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State | NV
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Zip | 89027-8852
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Country | US
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Telephone | 801-652-1788
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 E 1710 S
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City | ST GEORGE
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State | UT
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Zip | 84790-2293
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Country | US
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Telephone | 801-652-1788
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Fax |
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Authorized Official
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Title or Position | OFFICE SPECIALIST
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Name | MINDY MILLS
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Credential |
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Telephone | 435-313-0102
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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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