Healthcare Provider Details

I. General information

NPI: 1982327417
Provider Name (Legal Business Name): JUDY TUPPONCE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N MILITARY CIRCLE SUITE 1000
NORFOLK VA
23502
US

IV. Provider business mailing address

PO BOX 981
YORKTOWN VA
23692-0981
US

V. Phone/Fax

Practice location:
  • Phone: 833-782-2229
  • Fax:
Mailing address:
  • Phone: 757-296-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001260789
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: