Provider Demographics
NPI:1063676393
Name:CARAWAY PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:CARAWAY PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:870-291-1174
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:AR
Mailing Address - Zip Code:72561-0033
Mailing Address - Country:US
Mailing Address - Phone:870-291-1174
Mailing Address - Fax:870-346-5274
Practice Address - Street 1:9030 NORTH CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501
Practice Address - Country:US
Practice Address - Phone:870-291-1174
Practice Address - Fax:870-346-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01906363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty