Provider Demographics
NPI:1629626205
Name:DUKE, RITA (PMHNP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:DUKE
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 1:2705 SEASHORE CV
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1847
Mailing Address - Country:US
Mailing Address - Phone:757-390-7920
Mailing Address - Fax:
Practice Address - Street 1:1564 CROSSWAYS BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2841
Practice Address - Country:US
Practice Address - Phone:757-420-8002
Practice Address - Fax:757-420-1118
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA00241781152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry