MEDICARE: GLENISHIA K PULLIAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347C00000X	Private Vehicle	T62511423	VA

General Provider Information

NPI Number	:	1689138414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENISHIA K PULLIAM

Provider Business Mailing Address
First Line	:	3300 GORDON DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2657
Country	:	US
Telephone Number	:	804-721-0758
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 GORDON DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2657
Country	:	US
Telephone Number	:	804-721-0758
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2019
Last Update Date	:	04/12/2026

Similar Medicare Providers

1689516676 — MIND OVER MATTER SERVICES
Practice Location Address:

2007 S SYCAMORE ST
PETERSBURG, VA
23805-2726

Practice Phone: 804-799-8209
Practice Fax:

1568187763 — NATARSHA NICOLE BATTS
Practice Location Address:

119 PARK DR N
PETERSBURG, VA
23805-2445

Practice Phone: 804-892-2212
Practice Fax:

1336313253 — MRS. DAYNA M GARRETT ANP
Practice Location Address:

2623 PARK AVE
PETERSBURG, VA
23805-2420

Practice Phone: 804-471-4711
Practice Fax: 804-793-9195

1427726413 — AUN HUSSAIN PA-C
Practice Location Address:

2563 S CRATER RD
PETERSBURG, VA
23805-2407

Practice Phone: 804-520-1080
Practice Fax:

1598608978 — MY LIFE HAS DESTINY HOME CARE SERVICES LLC
Practice Location Address:

3131 S CRATER RD UNIT 3237
PETERSBURG, VA
23805-4058

Practice Phone: 678-557-5908
Practice Fax:

1649995804 — MY LIFE HAS DESTINY CONSULTING AND BILLING SERVICES LLC
Practice Location Address:

3131 S CRATER RD STE 3237
PETERSBURG, VA
23805-9218

Practice Phone: 678-557-5908
Practice Fax: 804-203-1657

Directions to “ GLENISHIA K PULLIAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.