Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 0024165911 | VA |
NPI | 1003066119 |
---|---|
Provider Name | Belinda James-Petersen |
First Address | Newport News, VA 23608-4413 |
Second Address | Newport News, VA 23608-4413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2008 |
Last Update Date | 14/07/2009 |