Healthcare Provider Details

I. General information

NPI: 1902742869
Provider Name (Legal Business Name): CHARIYA PREAP RN / PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 AXIS VALLEY PL
SAINT CLOUD FL
34772-7976
US

IV. Provider business mailing address

3950 AXIS VALLEY PL
SAINT CLOUD FL
34772-7976
US

V. Phone/Fax

Practice location:
  • Phone: 407-962-6543
  • Fax:
Mailing address:
  • Phone: 407-962-6543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9524741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: