Healthcare Provider Details

I. General information

NPI: 1356098792
Provider Name (Legal Business Name): DARIA GOUND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2022
Last Update Date: 03/06/2022
Certification Date: 03/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 FLOYD AVE
RICHMOND VA
23284-9026
US

IV. Provider business mailing address

11060 REGAL FOREST DR
SUWANEE GA
30024-1509
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-1981
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number259580
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: