Healthcare Provider Details

I. General information

NPI: 1912344979
Provider Name (Legal Business Name): PATIENCE NNENNA EKPERI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2013
Last Update Date: 12/28/2023
Certification Date: 12/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SENTARA CIR RM 2C
WILLIAMSBURG VA
23188-5713
US

IV. Provider business mailing address

100 SENTARA CIR RM 2C
WILLIAMSBURG VA
23188-5713
US

V. Phone/Fax

Practice location:
  • Phone: 757-984-7217
  • Fax: 757-984-7210
Mailing address:
  • Phone: 757-984-7217
  • Fax: 757-984-7120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT015405
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0102204967
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102204967
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: