Healthcare Provider Details

I. General information

NPI: 1376331967
Provider Name (Legal Business Name): OLENA SMAGLIY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLENA GERTSIY

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 GRASSFIELD PKWY
CHESAPEAKE VA
23322-7465
US

IV. Provider business mailing address

2232 ELON DR
VIRGINIA BEACH VA
23454-4313
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6797
  • Fax: 767-410-0390
Mailing address:
  • Phone: 720-324-0328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024193275
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: