DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MODERN INTEGRATIVE PSYCHIATRY, LLC

MEDICARE: MODERN INTEGRATIVE PSYCHIATRY, LLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1972387892
Entity Type Code : Organization
Provider Name (Legal Business Name) : MODERN INTEGRATIVE PSYCHIATRY, LLC
Provider Business Mailing Address
First Line : 13000 RIVERS BEND BLVD
Second Line :
City : CHESTER
State : VA
Zip : 23836-8632
Country : US
Telephone Number : 804-234-4893
Fax Number : 804-964-3175
Provider Business Practice Location Address
First Line : 13000 RIVERS BEND BLVD
Second Line :
City : CHESTER
State : VA
Zip : 23836-8632
Country : US
Telephone Number : 804-234-4893
Fax Number :
Authorized Official
Title or Position : PSYCHIATRIC NURSE PRACTITIONER/CEO
Name : PETITECHA WIMBUSH
Credential : PMHNP-BC
Telephone Number : 804-234-4893
Provider Enumeration Date : 08/22/2023
Last Update Date : 06/11/2024

Similar Medicare Providers

1841134236 — ZOE POLITTE
Practice Location Address:
13000 RIVERS BEND BLVD
CHESTER, VA
23836-8632
Practice Phone: 804-544-9044
Practice Fax:
1609201441 — COLONIAL ORTHOPAEDICS, INC
Practice Location Address:
13000 RIVERS BEND BLVD , STE E
CHESTER, VA
23836-8632
Practice Phone: 804-571-5007
Practice Fax: 804-667-2924
1659854073 — FIELDER WISE
Practice Location Address:
13000 RIVERS BEND BLVD
CHESTER, VA
23836-8632
Practice Phone: 804-544-9044
Practice Fax:
1245793744 — MS. ALEA NICOLE FINNEMORE BCBA
Practice Location Address:
13000 RIVERS BEND BLVD
CHESTER, VA
23836-8632
Practice Phone: 804-544-9044
Practice Fax: 804-715-4789
1285207522 — PETITECHA WIMBUSH PMHNP-BC
Practice Location Address:
13000 RIVERS BEND BLVD
CHESTER, VA
23836-8632
Practice Phone: 804-234-4893
Practice Fax:
1619621299 — PEDRO QUINTERO
Practice Location Address:
13000 RIVERS BEND BLVD
CHESTER, VA
23836-8632
Practice Phone: 703-232-4971
Practice Fax:

Directions to “MODERN INTEGRATIVE PSYCHIATRY, LLC ” 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.