Provider Demographics
NPI:1053103242
Name:CULBERTSON, DEIRDRE L (PMHNP)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:L
Last Name:CULBERTSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:DEIRDRE
Other - Middle Name:C
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:904 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3047
Mailing Address - Country:US
Mailing Address - Phone:804-564-9305
Mailing Address - Fax:
Practice Address - Street 1:8545 PATTERSON AVE STE 203
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6455
Practice Address - Country:US
Practice Address - Phone:757-603-4603
Practice Address - Fax:757-257-9146
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193278363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health