Individual
MARY KATHRYN MICHAELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
17068 LANKFORD HIGHWAY, EASTVILLE, VA 23347
(757) 414-0400
(757) 414-0569
Mailing address
20280 MARKET ST, ONANCOCK, VA 23417-1331
(757) 414-0400
(757) 414-0569
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024190998
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2023207144
AL
Other
Enumeration date
02/19/2024
Last updated
03/16/2026
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