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NPI 1235854639

NPI 1235854639 : J & K DIVINE CONNECTIONS LLC : CHESAPEAKE, VA

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General NPI Number Information
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    NPI Number           |    1235854639
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    Entity Type          |    Organization 
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    Legal Business Name  |    J & K DIVINE CONNECTIONS LLC 
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Dates
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    Enumeration Date     |    10/07/2022
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    Last Update Date     |    10/07/2022
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Provider Practice Location Address
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    Address Line         |    4100 2ND ST 
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    City                 |    CHESAPEAKE
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    State                |    VA
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    Zip                  |    23324-1547
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    Country              |    US
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    Telephone            |    757-524-4516
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4100 2ND ST 
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    City                 |    CHESAPEAKE
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    State                |    VA
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    Zip                  |    23324-1547
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    Country              |    US
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    Telephone            |    757-524-4516
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MISS JASMINE MARIE VALENTINE 
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    Credential           |    
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    Telephone            |    757-524-4516
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    343900000X
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    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
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    License Number       |    
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    License Number State |    
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