Healthcare Provider Details

I. General information

NPI: 1497139620
Provider Name (Legal Business Name): TESSA N BURRUS-SANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TESSA NICOLE BURRUS-SANDERS

II. Dates (important events)

Enumeration Date: 07/17/2015
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-3002
US

IV. Provider business mailing address

1060 FIRST COLONIAL RD
VIRGINIA BEACH VA
23454-3002
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-2323
  • Fax:
Mailing address:
  • Phone: 757-395-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172765
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024172765
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0024172765
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: