Provider Demographics
NPI:1497645170
Name:BLYTHE, TRESSA LUCAS (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:TRESSA
Middle Name:LUCAS
Last Name:BLYTHE
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 1:1311 ROMAN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-7718
Mailing Address - Country:US
Mailing Address - Phone:757-319-7285
Mailing Address - Fax:
Practice Address - Street 1:1311 ROMAN DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-7718
Practice Address - Country:US
Practice Address - Phone:757-319-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001259962163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health