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General NPI Number Information
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NPI Number | 1003776113
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Entity Type | Organization
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Legal Business Name | GUIDED BY GRACE MENTAL WELLNESS & SUPPORT INC
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 6649 WHISPERWOOD DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23234-6290
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Country | US
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Telephone | 804-206-2401
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Fax |
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Provider Business Mailing Address
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Address Line | 701 E FRANKLIN ST STE 105-1342
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City | RICHMOND
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State | VA
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Zip | 23219-2512
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Country | US
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Telephone | 804-206-2401
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GEORGETTE G NELSON
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Credential | DNP, PMHNP-BC
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Telephone | 804-206-2401
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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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