Provider Demographics
NPI:1760078760
Name:NORTH COUNTRY PSYCHIATRY
Entity type:Organization
Organization Name:NORTH COUNTRY PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE-MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:507-301-2627
Mailing Address - Street 1:58714 FRAZIER ST
Mailing Address - Street 2:
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470-3053
Mailing Address - Country:US
Mailing Address - Phone:507-301-2627
Mailing Address - Fax:
Practice Address - Street 1:58714 FRAZIER ST
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-3053
Practice Address - Country:US
Practice Address - Phone:507-301-6657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty