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JEFFREY TRAVIS NEEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
8901 THREE CHOPT RD STE D, RICHMOND, VA 23229
(804) 440-4878
Mailing address
1115 BOULDERS PKWY STE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 915-4607
(804) 560-9029

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024177807
VA
363L00000X
Nurse Practitioner
3007076
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000746201
ANTHEM
KY
05
201043930
IN
01
311192100
BLACK LUNG/US DEPT OF LABOR
KY
01
50034695
PASSPORT HEALTHPLAN
KY
05
7100192340
KY
Enumeration date
08/05/2011
Last updated
10/20/2020
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