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General NPI Number Information
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NPI Number | 1043768906
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Entity Type | Individual
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Provider Name | CARLA DIMIRIS APRN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 2057 PULASKI HWY STE 6
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City | NORTH EAST
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State | MD
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Zip | 21901-3744
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Country | US
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Telephone | 443-267-2969
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Fax |
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Provider Business Mailing Address
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Address Line | 9 NATHALIE DR
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City | HOCKESSIN
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State | DE
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Zip | 19707-1147
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Country | US
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Telephone | 302-426-2041
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Fax | 443-267-6121
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0000144
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AN-0011791
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License Number State | MD
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