Healthcare Provider Details

I. General information

NPI: 1992226955
Provider Name (Legal Business Name): RUTH KREIS-ORKOULAS, ARNP, PMHNP-BC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 E ATLANTIC BLVD
POMPANO BEACH FL
33060-6345
US

IV. Provider business mailing address

721 E ATLANTIC BLVD
POMPANO BEACH FL
33060-6345
US

V. Phone/Fax

Practice location:
  • Phone: 954-783-8300
  • Fax: 954-783-8302
Mailing address:
  • Phone: 954-783-8300
  • Fax: 954-783-8302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9392692
License Number StateFL

VIII. Authorized Official

Name: RUTH KREIS-ORKOULAS
Title or Position: SOLE PROPRIETOR
Credential:
Phone: 732-598-1777