Healthcare Provider Details

I. General information

NPI: 1477067288
Provider Name (Legal Business Name): WINTER LAUREN SEWARD-DIXON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 04/11/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 E PEMBROKE AVE
HAMPTON VA
23669-2445
US

IV. Provider business mailing address

1328 E PEMBROKE AVE
HAMPTON VA
23669-2445
US

V. Phone/Fax

Practice location:
  • Phone: 757-904-3319
  • Fax:
Mailing address:
  • Phone: 757-576-9138
  • Fax: 833-301-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number0024175663
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024175663
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: