Healthcare Provider Details

I. General information

NPI: 1851434294
Provider Name (Legal Business Name): NELDARA ANN DOWELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KINGSLEY LN SUITE 400
NORFOLK VA
23505-4604
US

IV. Provider business mailing address

100 KINGSLEY LN SUITE 400
NORFOLK VA
23505-4604
US

V. Phone/Fax

Practice location:
  • Phone: 757-451-0929
  • Fax: 757-434-8953
Mailing address:
  • Phone: 757-451-0929
  • Fax: 757-434-8953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024070037
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024070037
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: