MEDICARE: ERIN IMESON 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	363LF0000X	Family Nurse Practitioner	AP61596693	WA
2	363L00000X	Nurse Practitioner	4704261053	MI
3	363LF0000X	Family Nurse Practitioner	0024175242	VA

General Provider Information

NPI Number	:	1275818270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN IMESON NP

Provider Business Mailing Address
First Line	:	856 J CLYDE MORRIS BLVD STE A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23601-1318
Country	:	US
Telephone Number	:	757-316-5800
Fax Number	:	757-534-5190

Provider Business Practice Location Address
First Line	:	7212 BURNET RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-2253
Country	:	US
Telephone Number	:	512-867-6299
Fax Number	:

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

Provider Enumeration Date	:	10/21/2011
Last Update Date	:	02/18/2026

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