Individual provider · Type 1 NPI
Letitia J. Wallace, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Richmond, VA
NPI number
1619353224
Active
Practice location
8401 Mayland Dr # 5766
Richmond, VA 23294-4648
Other practice locations
- 20 W Bank St, Petersburg, VA 23803-3279 · (804) 862-8002
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 0001236086 (VA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 0024193187 (VA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1619353224
Letitia J. Wallace, PMHNP-BC's National Provider Identifier is 1619353224, issued on Aug 5, 2015. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Richmond, VA. The record was last updated on Jun 26, 2025.