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General NPI Number Information
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NPI Number | 1891683181
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Entity Type | Organization
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Legal Business Name | NIRVANA HAIR VA LLC
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 10019 JEFFERSON AVE
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City | NEWPORT NEWS
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State | VA
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Zip | 23605-1044
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Country | US
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Telephone | 757-254-7197
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Fax | 757-929-9095
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Provider Business Mailing Address
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Address Line | 33 WATERS EDGE CIR
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City | HAMPTON
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State | VA
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Zip | 23669-1920
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Country | US
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Telephone | 757-254-7197
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Fax | 757-929-9095
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MS. MAREE ANTONETTE NEWBY SANDERS
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Credential |
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Telephone | 757-254-7197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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