Provider Demographics
NPI:1770280570
Name:BAPTISTE, CARMELISA MARIE (PMHNP)
Entity type:Individual
Prefix:
First Name:CARMELISA
Middle Name:MARIE
Last Name:BAPTISTE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 MISTY ISLE LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-9703
Mailing Address - Country:US
Mailing Address - Phone:727-742-9395
Mailing Address - Fax:
Practice Address - Street 1:9092 SHOAL CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312
Practice Address - Country:US
Practice Address - Phone:850-966-2145
Practice Address - Fax:833-314-0408
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR48600163WM0705X
FL11025336363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical