Provider Demographics
NPI:1467910927
Name:A STRONG MIND PSYCHIATRY
Entity Type:Organization
Organization Name:A STRONG MIND PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKINNER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:719-339-7449
Mailing Address - Street 1:2950 PROFESSIONAL PL STE 125
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-8135
Mailing Address - Country:US
Mailing Address - Phone:719-900-1788
Mailing Address - Fax:719-434-9706
Practice Address - Street 1:2950 PROFESSIONAL PL STE 125
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-8135
Practice Address - Country:US
Practice Address - Phone:719-900-1788
Practice Address - Fax:719-434-9706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000155598Medicaid