Provider Demographics
NPI:1720637283
Name:NOURISH PSYCHIATRY, P.L.L.C.
Entity Type:Organization
Organization Name:NOURISH PSYCHIATRY, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:NIKOL
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP-BC
Authorized Official - Phone:479-321-4756
Mailing Address - Street 1:PO BOX 1032
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-1032
Mailing Address - Country:US
Mailing Address - Phone:479-321-4756
Mailing Address - Fax:888-331-5680
Practice Address - Street 1:1748 W SUNSET AVE STE B
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-5135
Practice Address - Country:US
Practice Address - Phone:479-321-4756
Practice Address - Fax:888-331-5680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-08
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty