Provider Demographics
NPI:1194523225
Name:MILLER, TYESHIA (DNP, RN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TYESHIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:
Credentials:DNP, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 ROBERVAL CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6730
Mailing Address - Country:US
Mailing Address - Phone:910-231-7912
Mailing Address - Fax:
Practice Address - Street 1:1705 ROBERVAL CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-6730
Practice Address - Country:US
Practice Address - Phone:910-231-7912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192789363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health