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General NPI Number Information
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NPI Number | 1205641453
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Entity Type | Individual
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Provider Name | MAYDELIS ESPIN
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Gender | Female
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 1430 HIGH ST
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-2867
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Country | US
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Telephone | 757-808-5288
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Fax |
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Provider Business Mailing Address
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Address Line | 5277 QUEEN BISHOP LN
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-3286
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024192601
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License Number State | VA
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