Individual
NICOLLE LIN STOPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1060 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-3002
(757) 395-8138
Mailing address
1060 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-3002
(757) 395-8138
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110004509
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212483602
—
TX
01
—
P00851105
RAILROAD MEDICARE
TX
Enumeration date
01/14/2010
Last updated
11/27/2016
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