Healthcare Provider Details

I. General information

NPI: 1467151373
Provider Name (Legal Business Name): DOREEN K BOATENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOREEN KYEREMEH KITSCHA

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OLD DENBIGH BLVD STE 1020A
NEWPORT NEWS VA
23602-2017
US

IV. Provider business mailing address

856 J CLYDE MORRIS BLVD STE A
NEWPORT NEWS VA
23601-1318
US

V. Phone/Fax

Practice location:
  • Phone: 757-875-2009
  • Fax:
Mailing address:
  • Phone: 757-316-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024186597
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number0024186597
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: