Healthcare Provider Details
I. General information
NPI: 1194478735
Provider Name (Legal Business Name): CARATIVE PSYCHIATRY NURSING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2022
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
739 BRYANT ST
SAN FRANCISCO CA
94107-1014
US
IV. Provider business mailing address
7901 4TH ST N STE 300
ST PETERSBURG FL
33702-4399
US
V. Phone/Fax
- Phone: 843-474-5578
- Fax: 843-790-1871
- Phone: 843-474-5578
- Fax: 843-790-1871
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
CYRONAK
Title or Position: OWNER
Credential: APRN
Phone: 843-474-5578