# BLUE RIDGE MIND AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235076852
- **Authorized official:** DR. MICHELLE WHITTAKER DNP PMHNP-BC FNP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (540) 467-3199

## Contact information

- **Practice address:** 4970 N SPRING DR, ROANOKE, VA 24019
- **Practice address phone:** (540) 467-3199
- **Mailing address:** 115 ROANOKE BLVD \# 5016, SALEM, VA 24153-4907
- **Mailing address phone:** (540) 467-3199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2026
- **Last updated:** 05/01/2026