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Organization
PLASTIC SURGERY ASSOCIATES OF TIDEWATER
Active
Organization
PLASTIC SURGERY ASSOCIATES OF TIDEWATER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAMANTHA MARIE PERSSON FNP-BC (NURSE PRACTITIONER)
(540) 493-7759
Entity
Organization
Contact information
Practice address
5818 HARBOUR VIEW BLVD, SUITE 200, SUFFOLK, VA 23435-3315
(757) 673-6000
(757) 673-6007
Mailing address
5818 HARBOUR VIEW BLVD, SUITE 200, SUFFOLK, VA 23435-3315
(757) 673-6000
(757) 673-6007
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024173410
VA
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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