YOUR NURSE PRACTITIONER PLLC

VIRGINIA BEACH, VA
NPI1801489711
Doing Business AsPANACEA BEHAVIORAL HEALTH & WELLNESS CENTER
Entity TypeOrganization
Authorized ContactSANDRA W NICHOLS
CEO
757-251-0879
Organization Subpart ?No
Primary Taxonomy261QM1300X Clinic/Center, Multi-Specialty
Additional Taxonomies101YM0800X Counselor, Mental Health
1041C0700X Social Worker, Clinical
225XH1300X Occupational Therapist, Human Factors
225XM0800X Occupational Therapist, Mental Health
363A00000X Physician Assistant
363LF0000X Nurse Practitioner, Family
363LP0808X Nurse Practitioner, Psych/Mental Health
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-02-11
Last Update Date2024-11-23
Business Address
YOUR NURSE PRACTITIONER PLLC
4360 SHORE DR STE 101
VIRGINIA BEACH, VA 23455-2994
Phone number: 757-251-0879
Mailing Address
YOUR NURSE PRACTITIONER PLLC
4360 SHORE DR STE 101
VIRGINIA BEACH, VA 23455-2994
Phone number: 757-251-0879