Healthcare Provider Details
I. General information
NPI: 1730154956
Provider Name (Legal Business Name): DARLENE EWTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/21/2006
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12200 WARWICK BLVD SUITE 510
NEWPORT NEWS VA
23601-2344
US
IV. Provider business mailing address
856 J CLYDE MORRIS BLVD SUITE A
NEWPORT NEWS VA
23601-1318
US
V. Phone/Fax
- Phone: 757-534-5700
- Fax: 757-534-5730
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | 0024070213 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: