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General NPI Number Information
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NPI Number | 1649884065
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Entity Type | Individual
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Provider Name | MIRANDA GAMGAH NJANTE APRN, FNP-PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 10445 E PIVITOL AVE
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City | MESA
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State | AZ
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Zip | 85212-8037
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Country | US
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Telephone | 480-910-1539
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Fax | 309-326-4439
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Provider Business Mailing Address
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Address Line | 10445 E PIVITOL AVE
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City | MESA
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State | AZ
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Zip | 85212-8037
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Country | US
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Telephone | 510-355-5652
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 246767
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License Number State | AZ
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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 | 2023057623
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License Number State | AZ
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