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General NPI Number Information
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NPI Number | 1669314993
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Entity Type | Individual
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Provider Name | TAKEYA LEMON
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Gender |
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 3829 GASKINS ROAD
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City | GLEN ALLEN
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State | VA
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Zip | 23060
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Country | US
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Telephone | 800-424-4518
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Fax |
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Provider Business Mailing Address
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Address Line | 5085 TOWNPOINT RD
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City | SUFFOLK
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State | VA
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Zip | 23435-2306
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024189934
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License Number State | VA
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