Individual
GWEN FROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6022 JEFFERSON AVE, SUITE 100, NEWPORT NEWS, VA 23605-3000
(757) 244-0511
(757) 320-2900
Mailing address
6022 JEFFERSON AVE, SUITE 100, NEWPORT NEWS, VA 23605-3000
(757) 244-0511
(757) 320-2900
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0153730830
—
VA
05
—
0513662736
—
VA
Enumeration date
05/05/2014
Last updated
05/05/2014
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