Healthcare Provider Details

I. General information

NPI: 1417492430
Provider Name (Legal Business Name): ROXY WONGUS-WILLIAMS FAMILY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2016
Last Update Date: 06/02/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7229 FOREST AVE. STE 111 HIGHLAND I BUILDING
RICHMOND VA
23226-3765
US

IV. Provider business mailing address

1329 KEMPSVILLE RD
CHESAPEAKE VA
23320-8132
US

V. Phone/Fax

Practice location:
  • Phone: 804-687-4793
  • Fax: 855-618-2623
Mailing address:
  • Phone: 757-312-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN2312465
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024186853
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: