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General NPI Number Information
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NPI Number | 1518778661
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Entity Type | Organization
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Legal Business Name | IMBUE MIND, PLLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 1123 S BROWNE ST
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City | SPOKANE
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State | WA
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Zip | 99204-3629
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Country | US
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Telephone | 509-289-2279
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Fax |
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Provider Business Mailing Address
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Address Line | 1314 S GRAND BLVD STE 2
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City | SPOKANE
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State | WA
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Zip | 99202-1174
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Country | US
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Telephone | 509-289-2279
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | DR. ANGELA TANKERSLEY KALEM
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Credential | APRN
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Telephone | 509-289-2279
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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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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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