Individual
SHAHAUNA LATIA MALLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
238 BATTLEFIELD BLVD S STE 200, CHESAPEAKE, VA 23322-5233
(757) 330-2491
(757) 974-0041
Mailing address
238 BATTLEFIELD BLVD S STE 200, CHESAPEAKE, VA 23322-5233
(757) 330-2491
(757) 974-0041
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024186470
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001227876
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
01
—
0024186470
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
02/08/2023
Last updated
08/25/2025
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