Healthcare Provider Details

I. General information

NPI: 1124842604
Provider Name (Legal Business Name): DANIELLE ANJULI YBARRA SCOTT CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 KEMPSVILLE RD STE 205
NORFOLK VA
23502-3957
US

IV. Provider business mailing address

880 KEMPSVILLE RD STE 205
NORFOLK VA
23502-3957
US

V. Phone/Fax

Practice location:
  • Phone: 757-761-9851
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number0001292073
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024192313
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: