1144656133 NPI number — ANGELA GARCIA NP

Table of content: ANGELA GARCIA NP (NPI 1144656133)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144656133 NPI number — ANGELA GARCIA NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARCIA
Provider First Name:
ANGELA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHAHEEN
Provider Other First Name:
ANGELA
Provider Other Middle Name:
SOUAD
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, NP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144656133
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4445 CORPORATION LN STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23462-3666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-623-0005
Provider Business Mailing Address Fax Number:
757-589-1129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 FIRST COLONIAL RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23454-2207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-623-0005
Provider Business Practice Location Address Fax Number:
757-389-5383
Provider Enumeration Date:
09/23/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  0001197487 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)