Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fanta Mian

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1477216224

Fanta Mian is a Nurse Practitioner in Hackensack, New Jersey. Qualified in 2021, 5 years ago. Practices with Rutgers Health Behavioral Health, a 117-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New Jersey.

Years since qualifying
5
Licensed in
NJ
In the registry since
2021
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Practice location Address checks out

25 E Salem St
Hackensack, NJ 07601-7427
Phone: (973) 534-2734
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ01202000 (NJ)

Record details

NPI number1477216224
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 19, 2021
Last updated in NPPESJune 2, 2022
Certification dateMay 29, 2022
Mailing address2552 Standish Ave, Union, NJ 07083-4939

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Rutgers Health Behavioral Health — 117 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Hackensack