MEDICARE: JANET HUDGINS DEHOUX NP

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	363LA2200X	Adult Health Nurse Practitioner	0024089558	VA

General Provider Information

NPI Number	:	1215932025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET HUDGINS DEHOUX NP

Provider Business Mailing Address
First Line	:	856 J CLYDE MORRIS BLVD
Second Line	:	SUITE A
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23601-1318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7547 MEDICAL DR
Second Line	:	SUITE 1200
City	:	GLOUCESTER
State	:	VA
Zip	:	23061-4351
Country	:	US
Telephone Number	:	804-693-2670
Fax Number	:	804-693-3704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/22/2013

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