Provider Demographics
NPI: | 1356964373 |
---|---|
Name: | A NEW DAY HEALTHCARE |
Entity type: | Organization |
Organization Name: | A NEW DAY HEALTHCARE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMANDA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | JOHNSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | FNP-BC |
Authorized Official - Phone: | 757-664-9700 |
Mailing Address - Street 1: | 1604 HILLTOP WEST CTR STE 215 |
Mailing Address - Street 2: | |
Mailing Address - City: | VIRGINIA BEACH |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23451-6196 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 757-664-9700 |
Mailing Address - Fax: | 757-664-9701 |
Practice Address - Street 1: | 1604 HILLTOP WEST CTR STE 215 |
Practice Address - Street 2: | |
Practice Address - City: | VIRGINIA BEACH |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23451-6196 |
Practice Address - Country: | US |
Practice Address - Phone: | 757-664-9700 |
Practice Address - Fax: | 757-664-9701 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-05-26 |
Last Update Date: | 2020-05-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Single Specialty |