Provider Demographics
NPI:1568284164
Name:DMS PSYCH PLLC
Entity type:Organization
Organization Name:DMS PSYCH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DINA
Authorized Official - Middle Name:MARIE WREN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN-CNP, PMHNP
Authorized Official - Phone:651-318-9648
Mailing Address - Street 1:2155 WOODLANE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3054
Mailing Address - Country:US
Mailing Address - Phone:651-318-9648
Mailing Address - Fax:866-534-4414
Practice Address - Street 1:2155 WOODLANE DR STE 201
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3054
Practice Address - Country:US
Practice Address - Phone:651-318-9648
Practice Address - Fax:866-534-4414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-26
Last Update Date:2024-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health