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NPI Code Detail

MEDICARE: GEORGE W PROFFITT NP

MEDICARE: GEORGE W PROFFITT NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024166588VA
2363L00000XNurse Practitioner0024166588VA

General Provider Information

NPI Number : 1306819628
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE W PROFFITT NP
Provider Business Mailing Address
First Line : 815 W POYTHRESS ST
Second Line :
City : HOPEWELL
State : VA
Zip : 23860-2532
Country : US
Telephone Number : 804-458-8557
Fax Number : 804-541-7113
Provider Business Practice Location Address
First Line : 815 W POYTHRESS ST
Second Line :
City : HOPEWELL
State : VA
Zip : 23860-2532
Country : US
Telephone Number : 804-458-8557
Fax Number : 804-541-7113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 06/13/2022

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Directions to “ GEORGE W PROFFITT NP” Practice Location

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