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Individual

SANDY ANNETTE VINCENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN.CEO

Contact information

Practice address
505 WASHINGTON ST STE 410, PORTSMOUTH, VA 23704-3530
(757) 337-0766
(757) 966-2197
Mailing address
505 WASHINGTON ST STE 410, PORTSMOUTH, VA 23704-3530
(757) 337-0766
(757) 966-2197

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO16855
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0157253466
VA
05
0160576655
VA
Enumeration date
08/03/2015
Last updated
08/03/2015
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