Healthcare Provider Details

I. General information

NPI: 1780910216
Provider Name (Legal Business Name): ELISE M FRENCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2009
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10510 JEFFERSON AVE SUITE D
NEWPORT NEWS VA
23601-3102
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 757-594-4720
  • Fax: 757-594-4735
Mailing address:
  • Phone: 757-594-4006
  • Fax: 757-534-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number0024168527
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: