Healthcare Provider Details

I. General information

NPI: 1902329162
Provider Name (Legal Business Name): NAKIA NATE HOWARD RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7151 RICHMOND RD STE 305
WILLIAMSBURG VA
23188-7234
US

IV. Provider business mailing address

4902 FALCON CREEK WAY APT 206
HAMPTON VA
23666-0967
US

V. Phone/Fax

Practice location:
  • Phone: 757-258-7778
  • Fax:
Mailing address:
  • Phone: 757-753-3250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number0402204195
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: