Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 0104556883 | VA |
NPI | 1396035473 |
---|---|
Provider Name | Dr. Jennet K Amonte |
First Address | Virginia Beach, VA 23452-2736 |
Second Address | Virginia Beach, VA 23451-2061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 21/11/2016 |