Mickey, Justin Randal

Mickey, Justin Randal is an individual health care provider with primary practice located at 2500 E Van Buren St , Phoenix AZ 85008-6037. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as his primary health care specialty. Mickey, Justin Randal can be contacted via phone (602) 220-6078.

Contact Information

Primary practice address
2500 E Van Buren St Phoenix AZ 85008-6037
Phone: (602) 220-6078
Fax: (602) 220-6293
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X TAP4472 Arizona

Profile Details

NPI number 1932467727
LBN Legal business name Mickey, Justin Randal
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2012
Last updated Apr 30th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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