Healthcare Provider Details

I. General information

NPI: 1073578811
Provider Name (Legal Business Name): ANNA GYURJYAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 J. CLYDE MORRIS BLVD BLD G
NEWPORT NEWS VA
23601
US

IV. Provider business mailing address

PO BOX 936
NORFOLK VA
23501-0936
US

V. Phone/Fax

Practice location:
  • Phone: 757-594-3636
  • Fax: 757-594-4310
Mailing address:
  • Phone: 757-594-3636
  • Fax: 757-594-4310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024165126
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: