Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mind Body Soul Wonderfully Made

Organization Nurse Practitioner · NPI 1457139354

Mind Body Soul Wonderfully Made is a Nurse Practitioner in Portsmouth, Virginia. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

355 Crawford St Ste 102
Portsmouth, VA 23704-2817
Phone: (757) 966-1270
Fax: (757) 966-2967
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1457139354
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tiffany Davis — Owner · (757) 966-1270
NPI enumeratedSeptember 20, 2023
Last updated in NPPESSeptember 20, 2023
Certification dateSeptember 20, 2023
Mailing address355 Crawford St Ste 102, Portsmouth, VA 23704-2817

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