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General NPI Number Information
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NPI Number | 1801754726
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE PSYCHIATRY
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 116 4TH ST SE
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City | FORT WALTON BEACH
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State | FL
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Zip | 32548-5425
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Country | US
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Telephone | 850-779-0881
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Fax | 850-308-2450
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Provider Business Mailing Address
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Address Line | 28 ARDMORE CT
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City | NICEVILLE
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State | FL
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Zip | 32578-3927
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Country | US
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Telephone | 864-320-3367
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Fax | 850-308-2450
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | TARA NICOLE KIDD
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Credential | MSN, APRN, PMHNP-BC
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Telephone | 864-320-3367
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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 |
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License Number State |
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