MEDICARE: V MENTAL WELLNESS, PLLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1639035116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V MENTAL WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	12760 ABERDEEN ST NE
Second Line	:
City	:	BLAINE
State	:	MN
Zip	:	55449-5845
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12760 ABERDEEN ST NE
Second Line	:
City	:	BLAINE
State	:	MN
Zip	:	55449-5845
Country	:	US
Telephone Number	:	786-493-8568
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMY VARGAS
Credential	:	DNP, PMHNP-BC
Telephone Number	:	786-493-8568

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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