KINGDOM RESERVES PSYCHIATRY NPI 1013861913

NPI Information

  • NPI: 1013861913
  • Provider Name: KINGDOM RESERVES PSYCHIATRY
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 901 ROYAL MILL AVE APT 335
    WAKE FOREST, NC
    ZIP 27587
  • Phone: (984) 231-9750

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NPI Details

KINGDOM RESERVES PSYCHIATRY is a psychiatric/mental health nurse practitioner in Wake Forest, NC. KINGDOM RESERVES PSYCHIATRY NPI is 1013861913. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

901 ROYAL MILL AVE APT 335
WAKE FOREST, NC
ZIP 27587-686
Phone: (984) 231-9750

The provider's authorized official is Tameka Davis .
The authorized official title is Pmhnp and has the following contact phone number (832) 978-4855.

The enumeration date for this NPI number is 2/26/2026 and was last updated on 2/26/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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