Provider Demographics
NPI:1215417001
Name:NORFUS, TAKENYA
Entity Type:Individual
Prefix:MRS
First Name:TAKENYA
Middle Name:
Last Name:NORFUS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TAKENYA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3031 KEMPTON PARK RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2552
Mailing Address - Country:US
Mailing Address - Phone:757-748-0271
Mailing Address - Fax:
Practice Address - Street 1:3031 KEMPTON PARK RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2552
Practice Address - Country:US
Practice Address - Phone:757-748-0271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician