Provider Demographics
NPI:1003036690
Name:SEGAL, CHERYL ANNETTE (NP)
Entity Type:Individual
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First Name:CHERYL
Middle Name:ANNETTE
Last Name:SEGAL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:2900 ERIKSEN CT
Mailing Address - Street 2:126
Mailing Address - City:VIRGINIA BCH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1238
Mailing Address - Country:US
Mailing Address - Phone:757-412-2641
Mailing Address - Fax:
Practice Address - Street 1:297 INDEPENDENCE BLVD
Practice Address - Street 2:126
Practice Address - City:VIRGINIA BCH
Practice Address - State:VA
Practice Address - Zip Code:23462-2911
Practice Address - Country:US
Practice Address - Phone:757-385-0511
Practice Address - Fax:757-743-5161
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2012-10-26
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Provider Licenses
StateLicense IDTaxonomies
VA0017001003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1861562472Medicaid