MEDICARE: NNEKA CHOTSANI PETERKIN

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1245182633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NNEKA CHOTSANI PETERKIN

Provider Business Mailing Address
First Line	:	1721 N KING ST
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-1909
Country	:	US
Telephone Number	:	757-742-9596
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 LOFTIS BLVD STE 103
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23606-2999
Country	:	US
Telephone Number	:	757-720-0099
Fax Number	:

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

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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