Individual provider · Type 1 NPI
Vivian Kisanga, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Puyallup, WA
NPI number
1821530155
Active
Practice location
18715 106th Avenue Ct E
Puyallup, WA 98374-8735
Mailing address
18715 106th Avenue Ct E Ste 260
Puyallup, WA 98374-8735
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP132350 (TX) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | AP61183787 (WA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1821530155
Vivian Kisanga, PMHNP-BC's National Provider Identifier is 1821530155, issued on Nov 17, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Puyallup, WA. The record was last updated on Aug 25, 2022.