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General NPI Number Information
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NPI Number | 1922521293
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Entity Type | Individual
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Provider Name | JARED SCOTT VEGA FNP-C, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 77 NEALY AVE
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City | LANGLEY AFB
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State | VA
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Zip | 23665-2040
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Country | US
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Telephone | 757-764-6840
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Fax |
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Provider Business Mailing Address
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Address Line | 439 W YORK ST
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City | NORFOLK
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State | VA
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Zip | 23510-1114
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Country | US
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Telephone | 718-938-0527
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 077291-23
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024180490
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License Number State | VA
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