Healthcare Provider Details

I. General information

NPI: 1093849721
Provider Name (Legal Business Name): DENISE A HARBIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 KINGS WAY SUITE 2700
WILLIAMSBURG VA
23185-2505
US

IV. Provider business mailing address

100 SENTARA CIR SUITE A
WILLIAMSBURG VA
23188-5713
US

V. Phone/Fax

Practice location:
  • Phone: 757-221-0110
  • Fax: 757-221-0851
Mailing address:
  • Phone: 757-984-7338
  • Fax: 757-984-8684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024166647
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: