Provider Demographics
NPI:1346817319
Name:GRAVITT, PAULA GAYLE (MS, PHMNP-BC)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:GAYLE
Last Name:GRAVITT
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Gender:F
Credentials:MS, PHMNP-BC
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Mailing Address - Street 1:1600 WHIPPOORWILL TRCE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-1275
Mailing Address - Country:US
Mailing Address - Phone:804-921-5580
Mailing Address - Fax:757-992-8583
Practice Address - Street 1:555 BELAIRE AVE STE 210
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4783
Practice Address - Country:US
Practice Address - Phone:757-828-5659
Practice Address - Fax:757-992-8583
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2025-02-08
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Provider Licenses
StateLicense IDTaxonomies
VA0024181555363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health