Healthcare Provider Details

I. General information

NPI: 1225792385
Provider Name (Legal Business Name): NURTURING NURSES LAB SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 THIMBLE SHOALS BLVD STE C
NEWPORT NEWS VA
23606-3636
US

IV. Provider business mailing address

742 THIMBLE SHOALS BLVD STE C
NEWPORT NEWS VA
23606-3636
US

V. Phone/Fax

Practice location:
  • Phone: 757-741-8380
  • Fax: 757-952-2775
Mailing address:
  • Phone: 757-741-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHEREKA JENKINS
Title or Position: AUTHORIZED AGENT
Credential: NURSE PRACTITIONER
Phone: 757-741-8380