Healthcare Provider Details

I. General information

NPI: 1225754948
Provider Name (Legal Business Name): LETISHA CORTEZ MS,GC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 BATTLEFIELD BLVD N STE 200
CHESAPEAKE VA
23320-4941
US

IV. Provider business mailing address

6350 CENTER DR STE 200
NORFOLK VA
23502-4107
US

V. Phone/Fax

Practice location:
  • Phone: 757-549-4403
  • Fax: 757-549-4332
Mailing address:
  • Phone: 579-055-5587
  • Fax: 757-213-5762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number0139000778
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: