Mariam Sophia Bouanane-smith, PMHNP-BC | |
5511 Princess Anne Rd Ste 200, Virginia Beach, VA 23462-3321 | |
(757) 704-4747 | |
(757) 250-9863 |
Full Name | Mariam Sophia Bouanane-smith |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 5511 Princess Anne Rd Ste 200, Virginia Beach, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053024026 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 0024187257 (Virginia) | Primary |
Entity Name | Virginia Pac Services Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073042800 PECOS PAC ID: 4587930672 Enrollment ID: O20171017002271 |
Entity Name | Nv Pacs 2 Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427534809 PECOS PAC ID: 0941550578 Enrollment ID: O20220802002024 |
Mailing Address | Practice Location Address |
---|---|
Mariam Sophia Bouanane-smith, PMHNP-BC 3500 Virginia Beach Blvd Ste 202, Virginia Beach, VA 23452-4445 Ph: (252) 621-2109 | Mariam Sophia Bouanane-smith, PMHNP-BC 5511 Princess Anne Rd Ste 200, Virginia Beach, VA 23462-3321 Ph: (757) 704-4747 |
Dr. Ameanthea Rica Blanco-knezovich, DNP, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1300 Diamond Springs Rd, Ste 503, Virginia Beach, VA 23455 Phone: 757-656-1665 | |
Clotilde Jorgina Ramos, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2025 Glenn Mitchell Dr, Virginia Beach, VA 23456 Phone: 757-507-1000 | |
Tonja Marie Devolgado, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2075 Glenn Mitchell Dr Ste 512, Virginia Beach, VA 23456 Phone: 757-507-8850 | |
Andrew Paul Leisring, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5500 Magnolia Run Cir Apt 107, Virginia Beach, VA 23464 Phone: 513-373-6017 | |
Stephanie Cole Oldfield, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 225 Clearfield Ave, Virginia Beach, VA 23462 Phone: 757-457-5110 Fax: 757-466-3411 | |
Ms. Patricia G Dudley, RNC, MSN, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1080 First Colonial Rd, Suite 300, Virginia Beach, VA 23454 Phone: 757-481-7222 Fax: 757-390-2935 | |
Keisha Monique Baxter, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 770 Lynnhaven Pkwy Ste 240, Virginia Beach, VA 23452 Phone: 757-802-4500 Fax: 757-226-9002 |