JUSTIN RANDAL MICKEY (NPI# 1932467727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932467727 |
| Entity Type | Individual |
| Full Name | JUSTIN RANDAL MICKEY |
| Credential | PMHNP |
| Practice Address |
2500 E Van Buren St Phoenix AZ 85008-6037 |
| Mailing Address |
3420 E Clarendon Ave Phoenix AZ 85018-5758 |
| Practice Telephone | 6022206078 |
| Practice Fax Number | 6022206293 |
| Mailing Telephone | 4805327765 |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2012-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
TAP4472 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2500 E VAN BUREN ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85008-6037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538170162 | State of Arizona | Pharmacy | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2006-08-10 |
| 1447873732 | State of Arizona State Dept of Finance | Community Based Residential Treatment Facility, Mental Illness | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2020-05-21 |
| 1528584547 | Nyanyiwa Vimba | Nurse Practitioner | 2500 E Van Buren St, Phoenix, AZ 85008 | 2017-08-22 |
| 1073068078 | Justin P Dennery | Nurse Practitioner | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2016-08-19 |
| 1255628525 | Sergio Boris Chavez | Psychiatry & Neurology | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2011-07-07 |
| 1518280734 | Viana Garcia Jackson | Counselor | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2010-03-02 |
| 1891928636 | Sheldon Epstein | General Practice | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2009-08-27 |
| 1366675324 | Conchita Tee | Internal Medicine | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2009-08-25 |
| 1548493547 | Richard Rowe | Family Medicine | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2009-08-25 |
| 1649403759 | Harold E Whitney | Family Medicine | 2500 E Van Buren St, Phoenix, AZ 85008-6037 | 2009-08-24 |
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| 1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
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| 1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
| 1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
| 1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
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| 1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
| 1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
| Find all providers in zip 85008 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1043838527 | Latasha Lynne Freeman | Nurse Practitioner | 1919 E Thomas Rd Bldg 5th, Phoenix, AZ 85016-7710 | 2020-07-10 |
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| 1578188025 | Joseph Medlin | Nurse Practitioner | 915 N 52nd St Apt 2010, Phoenix, AZ 85008-7934 | 2020-06-10 |
| 1750901088 | Foothills Psychiatric Services Pllc | Nurse Practitioner | 3546 E Windmere Dr, Phoenix, AZ 85048-7211 | 2020-04-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.