MEDICARE: NISHAUN BATTLE PH.D.

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
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1699399295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHAUN BATTLE PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 4072
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-8474
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9549 AMBERDALE DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-1256
Country	:	US
Telephone Number	:	804-362-7372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2020
Last Update Date	:	05/31/2020

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