Healthcare Provider Details

I. General information

NPI: 1003050220
Provider Name (Legal Business Name): VIGILANT HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2009
Last Update Date: 05/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 HAYWARD AVE SUITE D
CHESAPEAKE VA
23320-2200
US

IV. Provider business mailing address

1806 HAYWARD AVE SUITE D
CHESAPEAKE VA
23320-2200
US

V. Phone/Fax

Practice location:
  • Phone: 757-966-7271
  • Fax:
Mailing address:
  • Phone: 757-966-7271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. STEPHANIE M NASH
Title or Position: STEPHANIE NASH
Credential: LPN
Phone: 757-966-7271