Petheree Nissley, FNP-C, PMHNP-BC | |
2256 Irish Rd, Esmont, VA 22937-1945 | |
(434) 286-3602 | |
(434) 286-3819 |
Full Name | Petheree Nissley |
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Gender | Female |
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 2256 Irish Rd, Esmont, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932656048 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 0024173882 (Virginia) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 0024173882 (Virginia) | Primary |
Entity Name | Central Virginia Health Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134258601 PECOS PAC ID: 0345158432 Enrollment ID: O20031119000823 |
Entity Name | Community Access Network |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780058628 PECOS PAC ID: 8224333026 Enrollment ID: O20160216001199 |
Mailing Address | Practice Location Address |
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Petheree Nissley, FNP-C, PMHNP-BC 2256 Irish Rd, Esmont, VA 22937-1945 Ph: () - | Petheree Nissley, FNP-C, PMHNP-BC 2256 Irish Rd, Esmont, VA 22937-1945 Ph: (434) 286-3602 |
Brooke Bailey, MSN, RN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2256 Irish Rd, Esmont, VA 22937 Phone: 434-286-3602 | |
Loretta Raiford, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2256 Irish Rd, Esmont, VA 22937 Phone: 434-286-3602 |