MEDICARE: KANISHA BELT PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024181473	VA

General Provider Information

NPI Number	:	1083288740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANISHA BELT PMHNP-BC

Provider Business Mailing Address
First Line	:	508 S INDEPENDENCE BLVD STE 200
Second Line	:
City	:	VA BEACH
State	:	VA
Zip	:	23452-1178
Country	:	US
Telephone Number	:	757-761-5815
Fax Number	:

Provider Business Practice Location Address
First Line	:	249 CENTRAL PARK AVE STE 300-160
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3099
Country	:	US
Telephone Number	:	757-663-7547
Fax Number	:	757-802-3897

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	02/28/2024

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