Healthcare Provider Details

I. General information

NPI: 1659225761
Provider Name (Legal Business Name): THERESA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11818 ROCK LANDING DR STE 101
NEWPORT NEWS VA
23606-4394
US

IV. Provider business mailing address

11818 ROCK LANDING DR STE 101
NEWPORT NEWS VA
23606-4394
US

V. Phone/Fax

Practice location:
  • Phone: 757-595-3900
  • Fax: 757-595-0649
Mailing address:
  • Phone: 757-595-3900
  • Fax: 757-595-0649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024196142
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: