Healthcare Provider Details
I. General information
NPI: 1063326197
Provider Name (Legal Business Name): MONICA EMERALD WADDY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1881 UNIVERSITY DR
VIRGINIA BEACH VA
23453-8083
US
IV. Provider business mailing address
390 S MILITARY HWY APT 372G
NORFOLK VA
23502-5233
US
V. Phone/Fax
- Phone: 757-683-4297
- Fax:
- Phone: 804-480-9215
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 0001338082 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: