Healthcare Provider Details

I. General information

NPI: 1932276664
Provider Name (Legal Business Name): NAVAL MEDICAL CENTER PORTSMOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US

IV. Provider business mailing address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-2969
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License NumberARNP 9168588
License Number StateFL

VIII. Authorized Official

Name: CHRISTINA JAMIESON
Title or Position: PEDIATRIC NURSE PRACTITIONER
Credential: PNP
Phone: 757-953-2969