Individual
MRS. JOY REBEKAH GLADSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
3600 WOODS WAY, STATE FARM, VA 23160-0002
(804) 372-4799
Mailing address
3600 WOODS WAY, STATE FARM, VA 23160-0002
(804) 372-4799
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024173111
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001199040
REGISTERED NURSE
VA
01
—
0024173111
LISCENSED NURSE PRACTITIONER
VA
Enumeration date
01/13/2020
Last updated
04/05/2021
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