Healthcare Provider Details

I. General information

NPI: 1558343590
Provider Name (Legal Business Name): MRS. BELKYS FIAME
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BUTLER FARM RD
HAMPTON VA
23666-1564
US

IV. Provider business mailing address

456 MENCHVILLE RD S
NEWPORT NEWS VA
23602-7509
US

V. Phone/Fax

Practice location:
  • Phone: 757-251-7451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number0001177617
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024167410
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: