| Nidaa Llc | |
|
15850 N 35th Ave Ste 1 Phoenix AZ 85053-3885 | |
| (480) 799-4806 | |
| Not Available |
| Full Name | Nidaa Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 15850 N 35th Ave Ste 1, Phoenix, Arizona |
| Authorized Official Name and Position | Ngozika Vivian Amene (ADMINISTRATOR) |
| Authorized Official Contact | 4807994806 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nidaa Llc 15850 N 35th Ave Ste 1 Phoenix AZ 85053-3885 Ph: (480) 799-4806 | Nidaa Llc 15850 N 35th Ave Ste 1 Phoenix AZ 85053-3885 Ph: (480) 799-4806 |
| NPI Number | 1588324438 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 07/25/2024 |
| Certification Date | 07/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588324438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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