Healthcare Provider Details

I. General information

NPI: 1730922436
Provider Name (Legal Business Name): ESTRELLA STANELLE NESBIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 KEMPSVILLE RD STE 112
VIRGINIA BEACH VA
23464-6861
US

IV. Provider business mailing address

4661 BOXFORD RD
VIRGINIA BEACH VA
23456-4872
US

V. Phone/Fax

Practice location:
  • Phone: 757-276-1242
  • Fax:
Mailing address:
  • Phone: 559-308-5186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0730000744
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: