Healthcare Provider Details

I. General information

NPI: 1477245108
Provider Name (Legal Business Name): EMPOWERING THE HEALING FOR EXTERNAL LIVING, LLKC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 E LITTLE CREEK RD STE E3520E
NORFOLK VA
23518-3460
US

IV. Provider business mailing address

3520 E LITTLE CREEK RD STE D&E
NORFOLK VA
23518-3460
US

V. Phone/Fax

Practice location:
  • Phone: 757-620-2784
  • Fax: 405-449-0350
Mailing address:
  • Phone: 757-620-2784
  • Fax: 405-449-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TERESA DENISE PILES-HORTON
Title or Position: FAMILY NURSE PRACTITIONER
Credential: FNP-C, FNP-BC
Phone: 757-620-2784