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General NPI Number Information
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NPI Number | 1871484790
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Entity Type | Organization
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Legal Business Name | MILICARE PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 214 CHARLOTTE RD
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City | RUTHERFORDTON
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State | NC
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Zip | 28139-2914
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Country | US
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Telephone | 828-436-0228
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Fax |
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Provider Business Mailing Address
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Address Line | 145 RIVERSIDE DR
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City | RUTHERFORDTON
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State | NC
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Zip | 28139-8162
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Country | US
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Telephone | 337-842-4703
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC MENTAL HEALTH NURSE PRA
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Name | LARREN TEZENO
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Credential | PMHNP
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Telephone | 828-436-0228
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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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