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NPI Code Detail

MEDICARE: BREEZY MICHELLE MENDOZA PMHNP, FNP

MEDICARE: BREEZY MICHELLE MENDOZA PMHNP, FNP
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
1363L00000XNurse PractitionerAP61195153WA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner1160775TX
3363L00000XNurse PractitionerC-APN.0100289-C-NPCO
4363LP0808XPsychiatric/Mental Health Nurse PractitionerAP9650AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679016885
Entity Type Code : Individual
Provider Name (Legal Business Name) : BREEZY MICHELLE MENDOZA PMHNP, FNP
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number :
Provider Business Practice Location Address
First Line : 11851 N 51ST AVE STE F140
Second Line :
City : GLENDALE
State : AZ
Zip : 85304-2847
Country : US
Telephone Number : 480-882-4545
Fax Number : 623-242-1314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2016
Last Update Date : 05/11/2026

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Directions to “ BREEZY MICHELLE MENDOZA PMHNP, FNP” Practice Location

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