Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024088642 | VA |
NPI | 1003894106 |
---|---|
Provider Name | Stephanie Cole Oldfield |
First Address | Virginia Beach, VA 23462-1815 |
Second Address | Virginia Beach, VA 23462-1815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2006 |
Last Update Date | 23/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010346487 | (05) | VA |
10002237N | SENTARA (01) | VA |
S83097 | (02) |