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General NPI Number Information
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NPI Number | 1386268142
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Entity Type | Organization
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Legal Business Name | INTEGRAL HEALTH & WELLNESS
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Dates
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Enumeration Date | 06/07/2020
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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
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City | NORFOLK
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State | VA
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Zip | 23510-2607
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Country | US
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Telephone | 757-204-1901
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NAKESHIA LYNN MOUZON
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Credential | FNP-C, PMHNP-BC
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Telephone | 757-204-1901
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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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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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