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General NPI Number Information
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NPI Number | 1851965552
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Entity Type | Organization
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Legal Business Name | A RENEWED MIND PSYCHIATRIC SERVICES, LLC
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 522 W RIVERSIDE AVE STE 4053
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 800-549-0646
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Fax | 248-243-8914
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Provider Business Mailing Address
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Address Line | 522 W RIVERSIDE AVE STE 4053
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 800-549-0646
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Fax | 248-243-8914
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | ANGELA DENISE MILLER
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Credential | APRN-CNP
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Telephone | 662-736-0728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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