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General NPI Number Information
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NPI Number | 1538048012
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Entity Type | Organization
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Legal Business Name | INNOVATED HEALTH LLC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 10/19/2025
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Provider Practice Location Address
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Address Line | 2035 RIDGE END RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1028
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Country | US
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Telephone | 757-214-4469
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 RIDGE END RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1028
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Country | US
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Telephone | 757-214-4469
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/ OWNER
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Name | DEA JENIECE WOOLARD
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Credential | DNP-BC AND PMHNP
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Telephone | 757-214-4469
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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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