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General NPI Number Information
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NPI Number | 1306736277
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Entity Type | Individual
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Provider Name | LAQUITA MARIE STATEN
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Gender | Female
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 235 E PLUME ST
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City | NORFOLK
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State | VA
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Zip | 23510-1706
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Country | US
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Telephone | 757-672-3022
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Fax | 757-945-9387
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Provider Business Mailing Address
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Address Line | PO BOX 1035
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City | PORTSMOUTH
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State | VA
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Zip | 23705-1035
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Country | US
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Telephone | 757-672-3022
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Fax | 757-945-9387
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 0002049116
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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