Healthcare Provider Details

I. General information

NPI: 1407699069
Provider Name (Legal Business Name): AMYA CONLIFFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 COLONIAL AVE
NORFOLK VA
23517-1915
US

IV. Provider business mailing address

7221 NEWPORT AVE APT 201
NORFOLK VA
23505-3922
US

V. Phone/Fax

Practice location:
  • Phone: 833-782-2229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: