Provider Demographics
NPI:1639943426
Name:WYRICK, SASHA NICOLE
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:NICOLE
Last Name:WYRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3403
Mailing Address - Country:US
Mailing Address - Phone:757-343-2526
Mailing Address - Fax:
Practice Address - Street 1:720 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3403
Practice Address - Country:US
Practice Address - Phone:757-343-2526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula