Individual
GINA B STUKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3626 WESTERN BRANCH BLVD, PORTSMOUTH, VA 23707-2534
(757) 955-3390
Mailing address
3626 WESTERN BRANCH BLVD, PORTSMOUTH, VA 23707-2534
(757) 955-3390
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
PGP-0633736
VA
Other
Enumeration date
01/18/2023
Last updated
06/05/2023
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