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General NPI Number Information
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NPI Number | 1003637786
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Entity Type | Organization
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Legal Business Name | RENEWED MINDS HEALTHCARE LLC
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1728 VIRGINIA BEACH BLVD SUITE 114
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454
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Country | US
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Telephone | 757-546-4494
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Fax |
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Provider Business Mailing Address
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Address Line | 904 RILEY DR
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City | CHESAPEAKE
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State | VA
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Zip | 23322-7420
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Country | US
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Telephone | 803-466-2414
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. JUANITA PARKER
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Credential | NP
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Telephone | 757-546-4494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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