Provider Demographics
NPI:1245719749
Name:STRATA PSYCHIATRY PLLC
Entity type:Organization
Organization Name:STRATA PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN CNP
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:781-856-5437
Mailing Address - Street 1:1937 FREMONT AVE S APT 1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2938
Mailing Address - Country:US
Mailing Address - Phone:781-856-5437
Mailing Address - Fax:
Practice Address - Street 1:200 E TRAVELERS TRL STE 205
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4191
Practice Address - Country:US
Practice Address - Phone:612-254-9782
Practice Address - Fax:313-789-1417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4796363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty