Healthcare Provider Details

I. General information

NPI: 1922703743
Provider Name (Legal Business Name): REBECCA WELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 04/03/2023
Certification Date: 04/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 TOWN CENTER WAY
HAMPTON VA
23666-1999
US

IV. Provider business mailing address

40 TOWN CENTER WAY
HAMPTON VA
23666-1999
US

V. Phone/Fax

Practice location:
  • Phone: 757-896-0032
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0230036436
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: