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Organization
THE CHANGING TIDE BODY, MIND & SPIRIT P.C.
Active
Organization
THE CHANGING TIDE BODY, MIND & SPIRIT P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA GIULIANA MOORE-ZIEROW MSN, FNP-BC, PMHNP-B (CEO)
(804) 725-3041
Entity
Organization
Contact information
Practice address
10978 BUCKLEY HALL ROAD, MATHEWS, VA 23109-2310
(804) 725-3041
(804) 725-3510
Mailing address
PO BOX 327, MATHEWS, VA 23109-0327
(804) 725-3041
(804) 725-3041
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/25/2019
Last updated
06/12/2023
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