| Organization Name: | PSYCHNURSE P.C. |
| NPI Number: | 1053771428 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CYNTHIA M WITTCOFF (PRESIDENT) |
| Mailing Address: | 3000 County Road 42 W Suite 210 Burnsville |
| State: | MN US |
| Postal Code: | 553374824 |
| Phone Number: | 9528987578 |
| Fax Number: | 9528987592 |
| NPI Enumeration Date: | 02/29/2016 |
| NPI Last Update Date: | 02/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0808X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |