Healthcare Provider Details

I. General information

NPI: 1144811001
Provider Name (Legal Business Name): JONNI KATHLEEN FIELD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 J CLYDE MORRIS BLVD BLDG G602
NEWPORT NEWS VA
23601-1929
US

IV. Provider business mailing address

3507 HANOVER AVE
RICHMOND VA
23221-2207
US

V. Phone/Fax

Practice location:
  • Phone: 757-534-5511
  • Fax:
Mailing address:
  • Phone: 804-305-3417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110009275
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: