=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831072941
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAROLINA WOMEN'S PSYCHIATRY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 142 SHELLBANK DR
-----------------------------------------------------
City | SNEADS FERRY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28460-9539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-265-4897
-----------------------------------------------------
Fax | 910-265-4897
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 572
-----------------------------------------------------
City | SNEADS FERRY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28460-0572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-265-4897
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NURSE PRACTITIONER/ CEO
-----------------------------------------------------
Name | TARA NATE
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 910-265-4897
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------