Organization
FOUR CROWNE LEGACY LLC
Active
Other names
Crowne Initiative Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNORA BRADLEY MASON DNP, APRN, PMHNP-BC (PARTNER)
(757) 826-1300
Entity
Organization
Contact information
Practice address
6147 JEFFERSON AVE OFC 2, NEWPORT NEWS, VA 23605-1511
(757) 504-2191
Mailing address
317 PEACH TREE CRES, NEWPORT NEWS, VA 23602-7494
(757) 504-2191
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
11/24/2025
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