Provider Demographics
NPI:1740002898
Name:TRANQUIL TIDES PSYCHIATRY AND WELLNESS, PLLC
Entity type:Organization
Organization Name:TRANQUIL TIDES PSYCHIATRY AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:LEDEE
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:813-807-5269
Mailing Address - Street 1:25200 SAWYER FRANCIS LN STE 121
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6947
Mailing Address - Country:US
Mailing Address - Phone:813-807-5269
Mailing Address - Fax:813-807-5220
Practice Address - Street 1:25200 SAWYER FRANCIS LN STE 121
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6947
Practice Address - Country:US
Practice Address - Phone:813-807-5269
Practice Address - Fax:813-807-5220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty