Healthcare Provider Details

I. General information

NPI: 1962207639
Provider Name (Legal Business Name): VIRTUAL WARRIOR WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 N FRAZIER ST STE 102-F10
CONROE TX
77301-1239
US

IV. Provider business mailing address

1915 N FRAZIER ST STE 102-F10
CONROE TX
77301-1239
US

V. Phone/Fax

Practice location:
  • Phone: 806-591-4117
  • Fax: 806-214-3417
Mailing address:
  • Phone: 806-591-4117
  • Fax: 806-214-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY ANN JUSTICE
Title or Position: OWNER
Credential: MSN, APRN, PMHNP-BC
Phone: 806-591-4117