Provider Demographics
NPI:1215759162
Name:COASTAL CALM PSYCHIATRIC SOLUTIONS LLC
Entity type:Organization
Organization Name:COASTAL CALM PSYCHIATRIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:KERNZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-600-2256
Mailing Address - Street 1:7475 NIGHTINGALE RD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-3301
Mailing Address - Country:US
Mailing Address - Phone:352-600-2256
Mailing Address - Fax:352-204-1967
Practice Address - Street 1:7475 NIGHTINGALE RD
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34613-3301
Practice Address - Country:US
Practice Address - Phone:352-600-2256
Practice Address - Fax:352-204-1967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty