YOUR NURSE PRACTITIONER PLLC NPI 1801489711

NPI Information

  • NPI: 1801489711
  • Provider Name: YOUR NURSE PRACTITIONER PLLC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Doing Business As: PANACEA BEHAVIORAL HEALTH & WELLNESS CENTER
  • Address: 4360 SHORE DR STE 101
    VIRGINIA BEACH, VA
    ZIP 23455
  • Phone: (757) 251-0879

Map and Directions

Get Directions

NPI Details

YOUR NURSE PRACTITIONER PLLC is a multi-specialty clinic center in Virginia Beach, VA. YOUR NURSE PRACTITIONER PLLC NPI is 1801489711. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Panacea Behavioral Health & Wellness Center.

The provider's business location address is:

4360 SHORE DR STE 101
VIRGINIA BEACH, VA
ZIP 23455-994
Phone: (757) 251-0879
Fax: (984) 220-9437

The provider's authorized official is Sandra W Nichols .
The authorized official title is Ceo and has the following contact phone number (757) 251-0879.

The enumeration date for this NPI number is 2/11/2021 and was last updated on 11/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
21041C0700XSocial WorkerClinicalNo
3225XH1300XOccupational TherapistHuman FactorsNo
4225XM0800XOccupational TherapistMental HealthNo
5261QM1300XClinic/CenterMulti-SpecialtyYes
6363A00000XPhysician AssistantNo
7363LF0000XNurse PractitionerFamilyNo
8363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
9390200000XStudent in an Organized Health Care Education/Training ProgramNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.