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General NPI Number Information
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NPI Number | 1912614611
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Entity Type | Individual
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Provider Name | JAMES NDUNGU MAIGUA PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 8222 S 48TH ST STE 120
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City | PHOENIX
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State | AZ
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Zip | 85044-5368
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Country | US
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Telephone | 480-434-3251
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Fax |
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Provider Business Mailing Address
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Address Line | 36322 W ALHAMBRA ST
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City | MARICOPA
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State | AZ
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Zip | 85138-5308
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Country | US
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Telephone | 480-434-3251
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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 | 283446
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License Number State | AZ
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