Phoenixmides LLC
NPI #1023896586 in Petersburg, Virginia
Provider Information
- NPI Number
- 1023896586
- Entity Type
- Organization
- Organization Name
- Phoenixmides LLC
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Sep 18, 2023
- Last Updated
- Feb 12, 2024
Practice Location
- Address
- 591 OAKWOOD CIR
- City
- Petersburg
- State
- Virginia
- ZIP Code
- 23805-9339
- Phone
- (540) 204-2459
Authorized Official
- Name
- OLUWASEYI OLADIPUPO SOETAN, PMHNP-BC
- Title
- PSYCHIATRIC NURSE PRACTITIONER
- Phone
- (540) 204-2459
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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