Provider Demographics
NPI:1407470388
Name:MIDNIGHT SUN MENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:MIDNIGHT SUN MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH NP
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:STENSRUD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:520-313-9220
Mailing Address - Street 1:1416 E LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-3634
Mailing Address - Country:US
Mailing Address - Phone:520-313-9220
Mailing Address - Fax:
Practice Address - Street 1:1416 E LINDEN ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-3634
Practice Address - Country:US
Practice Address - Phone:520-313-9220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty