Healthcare Provider Details

I. General information

NPI: 1992649339
Provider Name (Legal Business Name): RESTORATION & REJUVENATION WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 OFFICE SQUARE LN STE 100
VIRGINIA BEACH VA
23462-3653
US

IV. Provider business mailing address

1100 KATHLEEN LN
CHESAPEAKE VA
23322-2395
US

V. Phone/Fax

Practice location:
  • Phone: 948-210-8927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TIFFINEY THOMPSON
Title or Position: OWNER
Credential: DNP
Phone: 948-210-8927