MEDICARE: TANGERINE PSYCHIATRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1508449810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANGERINE PSYCHIATRY

Provider Business Mailing Address
First Line	:	320 E WARM SPRINGS RD UNIT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 E WARM SPRINGS RD UNIT 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	520-461-3823
Fax Number	:

Authorized Official
Title or Position	:	PSYCHIATRIC MENTAL HEALTH NP
Name	:	SERAH MUIGAI
Credential	:	DNP
Telephone Number	:	520-461-3823

Provider Enumeration Date	:	05/04/2021
Last Update Date	:	07/24/2021

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