Provider Demographics
NPI:1114741949
Name:TELEHEALTHVA LLC
Entity type:Organization
Organization Name:TELEHEALTHVA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SMOOT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:804-893-0337
Mailing Address - Street 1:5930 HARBOUR PARK DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2169
Mailing Address - Country:US
Mailing Address - Phone:804-893-0337
Mailing Address - Fax:689-202-0711
Practice Address - Street 1:5930 HARBOUR PARK DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2169
Practice Address - Country:US
Practice Address - Phone:804-893-0337
Practice Address - Fax:689-202-0711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty