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NPI Code Detail

MEDICARE: YOUR NURSE PRACTITIONER PLLC

MEDICARE: YOUR NURSE PRACTITIONER PLLC
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
11041C0700XClinical Social Worker
2363A00000XPhysician Assistant
3390200000XStudent in an Organized Health Care Education/Training Program
4106H00000XMarriage & Family Therapist
5363LF0000XFamily Nurse Practitioner
6225XM0800XMental Health Occupational Therapist
7225XH1300XHuman Factors Occupational Therapist
8101YM0800XMental Health Counselor
9103TC0700XClinical Psychologist
10261QM1300XMulti-Specialty Clinic/Center
11363LP0808XPsychiatric/Mental Health Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801489711
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUR NURSE PRACTITIONER PLLC
Provider Business Mailing Address
First Line : 4360 SHORE DR STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-2994
Country : US
Telephone Number : 757-251-0879
Fax Number : 984-220-9437
Provider Business Practice Location Address
First Line : 4360 SHORE DR STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23455-2994
Country : US
Telephone Number : 757-251-0879
Fax Number : 984-220-9437
Authorized Official
Title or Position : CEO
Name : DR. SANDRA W NICHOLS
Credential : PHD, APRN, PMHNP-BC
Telephone Number : 757-251-0879
Provider Enumeration Date : 02/11/2021
Last Update Date : 01/16/2026

Similar Medicare Providers

1548513807 — MR. JAMES ALLEN JOHNSON JR. ED.S., LMFT, BCN
Practice Location Address:
4360 SHORE DR STE 101
VIRGINIA BEACH, VA
23455-2994
Practice Phone: 757-251-0879
Practice Fax: 984-220-9437
1770749202 — DR. SANDRA W NICHOLS PHD, APRN, PMHNP-BC,
Practice Location Address:
4360 SHORE DR STE 101
VIRGINIA BEACH, VA
23455-2994
Practice Phone: 757-251-0879
Practice Fax: 984-220-9437
1962532119 — DR. PATRICIA COLBY MFT, LPC
Practice Location Address:
4360 SHORE DR STE 101
VIRGINIA BEACH, VA
23455-2994
Practice Phone: 757-251-0879
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1659527570 — MRS. PATRICIA HILL STRAUSS A.P, D.O.M., M.S.O.M
Practice Location Address:
4360 SHORE DR STE 101
VIRGINIA BEACH, VA
23455-2994
Practice Phone: 757-251-9879
Practice Fax:
1770038093 — DR. MARY E DAVIS DNP, ARNP
Practice Location Address:
4360 SHORE DR STE 101
VIRGINIA BEACH, VA
23455-2994
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Practice Fax: 757-251-0879
1124576111 — ALISON LOPEZ AGPCNP-C
Practice Location Address:
4360 SHORE DR STE 101
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23455-2994
Practice Phone: 866-933-8387
Practice Fax:

Directions to “YOUR NURSE PRACTITIONER PLLC ” Practice Location

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