Healthcare Provider Details

I. General information

NPI: 1659462588
Provider Name (Legal Business Name): HELENE TERESE GINGRAS CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 HARTFORD RD
HAMPTON VA
23666-2409
US

IV. Provider business mailing address

2112 HARTFORD RD
HAMPTON VA
23666-2409
US

V. Phone/Fax

Practice location:
  • Phone: 757-826-7516
  • Fax: 757-826-6232
Mailing address:
  • Phone: 757-826-7516
  • Fax: 757-826-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number000111273
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024112703
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: