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General NPI Number Information
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NPI Number | 1902584295
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Entity Type | Individual
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Provider Name | NTOH NTOH PRINCEWILL SENIOR CARE M
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Gender | Male
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Dates
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Enumeration Date | 07/07/2023
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 801 W LITTLE CREEK RD STE 104
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City | NORFOLK
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State | VA
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Zip | 23505-2036
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Country | US
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Telephone | 757-866-2696
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Fax |
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Provider Business Mailing Address
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Address Line | 801 W LITTLE CREEK RD STE 104
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City | NORFOLK
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State | VA
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Zip | 23505-2036
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Country | US
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Telephone | 757-866-2696
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 0001307166
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 0002094523
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | VA
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