Healthcare Provider Details

I. General information

NPI: 1467481440
Provider Name (Legal Business Name): RENEE MESSINA ESSARY C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20901 CHESTERFIELD AVE
SOUTH CHESTERFIELD VA
23803-1903
US

IV. Provider business mailing address

436 CLAIRMONT CT SUITE 105
COLONIAL HEIGHTS VA
23834-1765
US

V. Phone/Fax

Practice location:
  • Phone: 804-526-3500
  • Fax: 804-526-4222
Mailing address:
  • Phone: 804-504-4671
  • Fax: 804-765-6490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024168282
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP005616B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: