Healthcare Provider Details

I. General information

NPI: 1760362453
Provider Name (Legal Business Name): DAVID L VENDT RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 GLENN MITCHELL DR
VIRGINIA BEACH VA
23456-0178
US

IV. Provider business mailing address

545 MANGO DR
VIRGINIA BEACH VA
23452-4411
US

V. Phone/Fax

Practice location:
  • Phone: 757-507-1099
  • Fax:
Mailing address:
  • Phone: 757-681-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number0001139487
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: