0010-00817
Active
No
02/21/2007
02/05/2027
Active Supervisor
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
Address
Tideline Psych PLLC
226 N Front St. #129
Wilmington, NC 28401
910-469-4690
http://www.tidelinepsych.com
Information
Tuesday
No
No
No
No
Yes
PA School
| School | Graduation |
| East Carolina University Physician Assistant Program | 2006 |
Area of Practice
| Area Of Practice | Primary |
| Emergency Medicine | |
| Psychiatry | Yes |
Current Membership in Medical Professional Organizations
| Membership |
| American Academy of Physician Assistants |
| North Carolina Academy of Physician Assistants |
| Physician Assistant Education Association |
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| Dean/ Program Director | West Coast University |
Los Angeles, CA, US
|
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
| Date | Description | Link |
| None Reported |
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
| Date | Description | Link |
| None Reported |
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |