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General NPI Number Information
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NPI Number | 1437955226
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Entity Type | Organization
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Legal Business Name | PAULA G. GRAVITT, LLC
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 555 BELAIRE AVE
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City | CHESAPEAKE
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State | VA
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Zip | 23320-4783
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Country | US
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Telephone | 757-828-5659
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Fax | 757-992-8583
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Provider Business Mailing Address
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Address Line | 1600 WHIPPOORWILL TRCE
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City | CHESAPEAKE
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State | VA
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Zip | 23322-1275
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Country | US
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Telephone | 804-921-5580
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Fax |
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Authorized Official
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Title or Position | OWNER/PMHNP
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Name | MRS. PAULA GAYLE GRAVITT
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Credential | PMHNP-BC
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Telephone | 757-828-5659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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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 | 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 #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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