Provider Demographics
NPI:1376630988
Name:GEORGE, NEOMA SMITH (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:NEOMA
Middle Name:SMITH
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3000 COLISEUM DR FL 2
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5963
Mailing Address - Country:US
Mailing Address - Phone:757-736-1347
Mailing Address - Fax:757-736-1350
Practice Address - Street 1:3000 COLISEUM DR FL 2
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5963
Practice Address - Country:US
Practice Address - Phone:757-736-1347
Practice Address - Fax:757-736-1350
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA24166019207RC0001X
VA0024166019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA78563NOtherOPTIMA
VAQ18522Medicare UPIN
VA011813C00Medicare Oscar/Certification