Individual
DANIELLE BIBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3640 HIGH ST, SUITE 1A, PORTSMOUTH, VA 23707
(757) 215-3565
(757) 397-8026
Mailing address
3640 HIGH ST, SUITE 1A, PORTSMOUTH, VA 23707-3213
(757) 215-3565
(757) 397-8026
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024174076
VA
Other
Enumeration date
01/10/2017
Last updated
08/09/2018
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