Individual
SHANTI SOPHIA POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2168 GENERAL BOOTH BLVD STE 510, VIRGINIA BEACH, VA 23454-5804
(757) 702-8122
(757) 702-2184
Mailing address
2168 GENERAL BOOTH BLVD STE 510, VIRGINIA BEACH, VA 23454-5804
(757) 702-8122
(757) 702-2184
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004265
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110004265
VA MEDICAL LICENSE
VA
Enumeration date
06/28/2013
Last updated
09/15/2025
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