Individual
DENEICE WICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
2551 ELTHAM AVE STE A, NORFOLK, VA 23513-2514
(757) 622-0700
Mailing address
6115 TIDEWATER DR APT 125, NORFOLK, VA 23509-0015
(803) 565-9758
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024187449
VA
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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