MEDICARE: CENTER FOR PALLIATIVE AND INTEGRATIVE CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1215764030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR PALLIATIVE AND INTEGRATIVE CARE, LLC

Provider Business Mailing Address
First Line	:	704 THIMBLE SHOALS BLVD STE 500A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4555
Country	:	US
Telephone Number	:	757-599-1066
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 THIMBLE SHOALS BLVD STE 500A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-4555
Country	:	US
Telephone Number	:	757-599-1066
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. EVA FRANCIS
Credential	:	NP
Telephone Number	:	757-870-3938

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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