Healthcare Provider Details

I. General information

NPI: 1235014606
Provider Name (Legal Business Name): TERESA ABIOLA ADENAIKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11783 ROCK LANDING DR
NEWPORT NEWS VA
23606-4431
US

IV. Provider business mailing address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7473
  • Fax:
Mailing address:
  • Phone: 757-668-7007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024194114
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: