Healthcare Provider Details

I. General information

NPI: 1982529343
Provider Name (Legal Business Name): LASHUNA SPENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4136 NAUTILUS AVE STE 101
CHESAPEAKE VA
23325-2523
US

IV. Provider business mailing address

4136 NAUTILUS AVE STE 101
CHESAPEAKE VA
23325-2523
US

V. Phone/Fax

Practice location:
  • Phone: 757-553-2387
  • Fax:
Mailing address:
  • Phone: 757-553-2387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number0735000467
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: