Healthcare Provider Details

I. General information

NPI: 1851136337
Provider Name (Legal Business Name): MYKA LAFRANCE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7544 MEDICAL DR STE B-1
GLOUCESTER VA
23061-4299
US

IV. Provider business mailing address

856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS VA
23601-1318
US

V. Phone/Fax

Practice location:
  • Phone: 804-693-9037
  • Fax:
Mailing address:
  • Phone: 757-316-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024190535
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: