Provider Demographics
NPI:1154989408
Name:BINNS, GENISE MAXINE
Entity type:Individual
Prefix:
First Name:GENISE
Middle Name:MAXINE
Last Name:BINNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11838 ROCK LANDING DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4232
Mailing Address - Country:US
Mailing Address - Phone:757-873-0735
Mailing Address - Fax:757-873-0735
Practice Address - Street 1:11838 ROCK LANDING DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4232
Practice Address - Country:US
Practice Address - Phone:757-873-0735
Practice Address - Fax:757-873-0735
Is Sole Proprietor?:No
Enumeration Date:2019-06-02
Last Update Date:2020-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177594363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health