Healthcare Provider Details

I. General information

NPI: 1871314948
Provider Name (Legal Business Name): JEWIL HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 INDIAN RIVER RD STE 1A
CHESAPEAKE VA
23325-3100
US

IV. Provider business mailing address

4310 INDIAN RIVER RD STE 1A
CHESAPEAKE VA
23325-3100
US

V. Phone/Fax

Practice location:
  • Phone: 757-927-0313
  • Fax: 757-921-8003
Mailing address:
  • Phone: 757-927-0313
  • Fax: 757-927-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. VERONICA WILLIAMS
Title or Position: OWNER
Credential: PMHNP-BC, FNP-BC
Phone: 757-927-0313