Wellness Provider Services LLC
Nurse Practitioner, Psych/Mental Health in Virginia Beach, VA. Organization (NPI-2).
NPI number1942005335
StatusActive
Last updated in NPPESMar 10, 2025
Details
- NPI
- 1942005335
- Entity type
- Organization (NPI-2)
- Legal business name
- Wellness Provider Services LLC
- Organization subpart
- No
- Enumeration date
- Feb 18, 2025
- Certification date
- Mar 10, 2025
- Last updated
- Mar 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
780 Lynnhaven Pkwy Ste 400Virginia Beach, VA 23452-7332
Phone 757-650-1762
Mailing address
780 Lynnhaven Pkwy Ste 400Virginia Beach, VA 23452-7332
Phone 757-650-1762
Other practice locations
1209 Moorefield Ct
Virginia Beach, VA 23454-2210
Virginia Beach, VA 23454-2210
Phone 757-650-1762
Authorized official
Tera Stanistreet
Manager
7576501762
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