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NPI Code Detail

MEDICARE: ANTOINETTE DENISE FALTZ

MEDICARE: ANTOINETTE DENISE FALTZ
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
1164X00000XLicensed Vocational Nurse345898TX

General Provider Information

NPI Number : 1992420517
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTOINETTE DENISE FALTZ
Provider Business Mailing Address
First Line : 1728 VIRGINIA BEACH BLVD STE 113
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-4533
Country : US
Telephone Number : 757-437-0411
Fax Number : 757-552-0378
Provider Business Practice Location Address
First Line : 1728 VIRGINIA BEACH BLVD STE 113
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-4533
Country : US
Telephone Number : 757-437-0411
Fax Number : 757-552-0378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2022
Last Update Date : 10/06/2022

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Directions to “ ANTOINETTE DENISE FALTZ ” Practice Location

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