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Individual

DEBORAH K. VAN DEN BERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
GNP

Contact information

Practice address
17385 LANKFORD HWY, PARKSLEY, VA 23421-3882
(757) 665-5996
(757) 665-5973
Mailing address
17385 LANKFORD HWY, PARKSLEY, VA 23421-3882
(757) 665-5996
(757) 665-5973

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0024168528
VA
363LG0600X
Gerontology Nurse Practitioner
4704176420
MI

Other

Enumeration date
06/16/2009
Last updated
06/30/2010
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