Provider Demographics
NPI:1336854165
Name:PEACE OF MIND PSYCHIATRY, LLC
Entity type:Organization
Organization Name:PEACE OF MIND PSYCHIATRY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIERSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:WIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:470-206-5640
Mailing Address - Street 1:3400 CHAPEL HILL RD # 10039
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 CHAPEL HILL RD
Practice Address - Street 2:SUITE 100/39
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1739
Practice Address - Country:US
Practice Address - Phone:470-206-5640
Practice Address - Fax:404-348-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty