Individual provider Active NPI

Nearesa A Myrie, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Haines City, FL
National Provider Identifier
1619662897
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11023869 Issued in FL
Practice address
278 Archer Way
Haines City, FL 33844-5416
Phone
(954) 404-4821
NPI assigned
Apr 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11023869 FL Primary

Addresses

Primary practice location

278 Archer Way
Haines City, FL 33844-5416

Mailing address

278 Archer Way
Haines City, FL 33844-5416
Phone (954) 404-4821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11023869FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1619662897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 ARCHER WAY",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445416",
            "telephone_number": "954-404-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 ARCHER WAY",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338445416",
            "telephone_number": "954-404-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYRIE",
        "first_name": "NEARESA",
        "middle_name": "A",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-05",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11023869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haines City, FL

Sources for this page

Verify at the official NPI Registry.