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General NPI Number Information
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NPI Number | 1366383317
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Entity Type | Organization
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Legal Business Name | MATERNA LLC
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 3515 BURLINGTON ST
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City | SUFFOLK
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State | VA
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Zip | 23435
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Country | US
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Telephone | 757-279-8195
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Fax |
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Provider Business Mailing Address
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Address Line | 110 COLISEUM XING # 5124
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City | HAMPTON
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State | VA
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Zip | 23666-5971
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Country | US
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Telephone | 757-279-8195
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRALEESIA WARREN
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Credential | RN
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Telephone | 757-279-8195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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