Healthcare Provider Details

I. General information

NPI: 1932959822
Provider Name (Legal Business Name): TESSA MUSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE
NORFOLK VA
23507-1912
US

IV. Provider business mailing address

328 E FREEMASON ST APT 203C
NORFOLK VA
23510-2587
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-5600
  • Fax:
Mailing address:
  • Phone: 571-314-1017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0116040885
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: