Provider Demographics
NPI:1447017975
Name:MYATT PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:MYATT PSYCHIATRIC SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AMIEE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:MYATT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:252-696-8911
Mailing Address - Street 1:1255 NC HIGHWAY 55 W
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-8639
Mailing Address - Country:US
Mailing Address - Phone:252-696-8911
Mailing Address - Fax:
Practice Address - Street 1:1255 NC HIGHWAY 55 W
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-8639
Practice Address - Country:US
Practice Address - Phone:252-696-8911
Practice Address - Fax:866-651-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty