Provider Demographics
NPI:1801503008
Name:MEKANG, LINDA M (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:MEKANG
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9550 S VIA BANDERA
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-2167
Mailing Address - Country:US
Mailing Address - Phone:240-688-5720
Mailing Address - Fax:
Practice Address - Street 1:2802 E DISTRICT ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2081
Practice Address - Country:US
Practice Address - Phone:240-688-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-28
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ246918363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty