Healthcare Provider Details

I. General information

NPI: 1467003483
Provider Name (Legal Business Name): VERONICA CORY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CHILDRENS LN
NORFOLK VA
23507-1910
US

IV. Provider business mailing address

813 SATINWOOD CT
CHESAPEAKE VA
23322-5882
US

V. Phone/Fax

Practice location:
  • Phone: 757-668-7452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number0024178258
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: