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General NPI Number Information
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NPI Number | 1669258232
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Entity Type | Individual
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Provider Name | NADINE ROSE BARRUGA
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Gender | Female
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 4225 SHORE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2870
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Country | US
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Telephone | 757-460-8868
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Fax |
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Provider Business Mailing Address
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Address Line | 2066 NICKLAUS DR
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City | SUFFOLK
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State | VA
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Zip | 23435-4104
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Country | US
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Telephone | 760-954-4696
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305214887
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License Number State | VA
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