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General NPI Number Information
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NPI Number | 1013829811
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Entity Type | Individual
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Provider Name | JASON EGTS
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Gender | Male
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 1881 UNIVERSITY DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-8083
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Country | US
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Telephone | 757-683-4297
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Fax | 757-683-5253
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Provider Business Mailing Address
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Address Line | 121 ABBERLY DR APT 103
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City | STAFFORD
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State | VA
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Zip | 22554-6552
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Country | US
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Telephone | 754-283-1185
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 28181809A
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License Number State | IN
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