Healthcare Provider Details

I. General information

NPI: 1619869963
Provider Name (Legal Business Name): AMANDA CELIA ESCOBAR SMAILES DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 SOUTHAMPTON AVE
NORFOLK VA
23510-1021
US

IV. Provider business mailing address

728 FENTRESS RD
CHESAPEAKE VA
23322-3408
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-9466
  • Fax:
Mailing address:
  • Phone: 757-513-5056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024194509
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSMAI-2DXWV
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001240565
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: