Healthcare Provider Details

I. General information

NPI: 1265336754
Provider Name (Legal Business Name): STEADY TIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 CANTERWOOD DR
WILMINGTON NC
28401-7300
US

IV. Provider business mailing address

2311 CANTERWOOD DR
WILMINGTON NC
28401-7300
US

V. Phone/Fax

Practice location:
  • Phone: 910-763-2385
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATHERINE NEAVE
Title or Position: PMHNP
Credential: PMHNP
Phone: 203-295-5123