Provider Demographics
NPI:1578160875
Name:NORTHINGTON, TRICIA DAIGLE (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:DAIGLE
Last Name:NORTHINGTON
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 1:20213 EAGLE COVE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23803-1097
Mailing Address - Country:US
Mailing Address - Phone:315-727-0206
Mailing Address - Fax:
Practice Address - Street 1:20213 EAGLE COVE CT
Practice Address - Street 2:
Practice Address - City:SOUTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23803-1097
Practice Address - Country:US
Practice Address - Phone:315-727-0206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180293363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health