Individual
REGINA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPNP-BC
Contact information
Practice address
5320 PROVIDENCE RD STE 301-101, VIRGINIA BEACH, VA 23464-4122
(757) 413-7600
Mailing address
5017 HOLLY FARMS DR, VIRGINIA BEACH, VA 23462-1929
(408) 612-6885
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
0024174704
VA
363LG0600X
Gerontology Nurse Practitioner
0024174704
VA
363LP2300X
Primary Care Nurse Practitioner
Primary
0024174704
VA
Other
Enumeration date
03/27/2017
Last updated
11/12/2018
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