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General NPI Number Information
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NPI Number | 1164788519
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Entity Type | Individual
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Provider Name | NAKESHIA LYNN MOUZON FNP, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 533 NEWTOWN RD STE 115
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-5758
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Country | US
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Telephone | 757-204-1901
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 GRANBY ST STE 20
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City | NORFOLK
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State | VA
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Zip | 23510-2622
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Country | US
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Telephone | 757-204-1901
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Fax | 908-504-8194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0024170001
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024170001
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License Number State | VA
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