Individual
ELISE R DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, APRN
Contact information
Practice address
400 MEDICAL DR, HAMPTON, VA 23666-1767
(757) 788-0400
(757) 788-0957
Mailing address
300 MEDICAL DR, HAMPTON, VA 23666-1765
(757) 788-0300
(757) 788-0969
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024189032
VA
Other
Enumeration date
02/14/2024
Last updated
03/10/2025
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