Healthcare Provider Details

I. General information

NPI: 1952379505
Provider Name (Legal Business Name): MARY O TROSIEN FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BATTLEFIELD BLVD N
CHESAPEAKE VA
23320
US

IV. Provider business mailing address

667 KINGSBOROUGH SQ STE 101
CHESAPEAKE VA
23320-4999
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-3085
  • Fax: 757-312-6550
Mailing address:
  • Phone: 757-842-4481
  • Fax: 757-312-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024130644
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: