Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 0024166121 | VA |
NPI | 1063658193 |
---|---|
Provider Name | Josephine Julia Rekant |
First Address | Virginia Beach, VA 23454-2406 |
Second Address | Virginia Beach, VA 23454-2406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2008 |
Last Update Date | 20/01/2021 |