Individual
JACQUETTA DELSHAWN GARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1020 FIRST COLONIAL RD STE A, VIRGINIA BEACH, VA 23454-3078
(757) 395-1850
(757) 222-9360
Mailing address
2827 VICTORIA AVE, NORFOLK, VA 23504-4523
(757) 718-2175
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
0001213031
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024180091
VA
Other
Enumeration date
03/25/2020
Last updated
10/29/2024
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