Individual
DR. JANA NUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2205 EXECUTIVE DR STE A, HAMPTON, VA 23666-2948
(757) 825-4273
(757) 825-4276
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101237740
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010203538
—
VA
01
—
180680
BCBS
VA
01
—
96723
SENTARA
—
Enumeration date
06/21/2006
Last updated
12/19/2019
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