Provider Demographics
NPI:1487292736
Name:FLETCHER, KATINA (PMHNP)
Entity type:Individual
Prefix:MS
First Name:KATINA
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6767 FOREST HILL AVE STE 234
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1851
Mailing Address - Country:US
Mailing Address - Phone:804-320-1395
Mailing Address - Fax:
Practice Address - Street 1:6767 FOREST HILL AVE STE 234
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1851
Practice Address - Country:US
Practice Address - Phone:804-320-1395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001210296363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health