Provider Demographics
NPI:1891954467
Name:NANCY L. CARR,R.N.&N.P. IN PSYCHIATRY, PLLC
Entity Type:Organization
Organization Name:NANCY L. CARR,R.N.&N.P. IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NPP
Authorized Official - Phone:718-873-6893
Mailing Address - Street 1:92 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3253
Mailing Address - Country:US
Mailing Address - Phone:718-873-6893
Mailing Address - Fax:
Practice Address - Street 1:2336 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2346
Practice Address - Country:US
Practice Address - Phone:718-873-6893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-08
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400557363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty