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Individual

MS. SHAUGHANASSEE B VINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
5320 PROVIDENCE RD STE 100, VIRGINIA BEACH, VA 23464-4122
(757) 550-4132
Mailing address
5320 PROVIDENCE RD STE 100, VIRGINIA BEACH, VA 23464-4122
(757) 550-4132

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
0024170738
VA
367A00000X
Advanced Practice Midwife
236069
CA
367A00000X
Advanced Practice Midwife
AC003102
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487101747
VA
Enumeration date
04/29/2013
Last updated
12/31/2022
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