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General NPI Number Information
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NPI Number | 1407554645
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Entity Type | Individual
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Provider Name | REGINA BARBARA NAMATOVU PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 1936 E SAINT ANNE AVE
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City | PHOENIX
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State | AZ
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Zip | 85042-9100
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Country | US
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Telephone | 214-772-4835
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 ALBARES
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-6511
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Country | US
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Telephone | 214-772-4835
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Fax |
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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 | 1111082
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 290096
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License Number State | AZ
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