Healthcare Provider Details

I. General information

NPI: 1265336192
Provider Name (Legal Business Name): DEMETRIUS SHIRNETTLE FLOYD PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 BRUTON CT
CHESAPEAKE VA
23322-4377
US

IV. Provider business mailing address

115 BRUTON CT
CHESAPEAKE VA
23322-4377
US

V. Phone/Fax

Practice location:
  • Phone: 571-285-7422
  • Fax:
Mailing address:
  • Phone: 757-410-2644
  • Fax: 757-819-6990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024199052
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: