Provider Demographics
NPI:1467439224
Name:COMER, NAOMI CARROLL (FNP)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:CARROLL
Last Name:COMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 HIALEAH DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3220
Mailing Address - Country:US
Mailing Address - Phone:757-467-6839
Mailing Address - Fax:
Practice Address - Street 1:1721ADMIRAL TAUSSIG BLVD
Practice Address - Street 2:BRANCH MEDICAL CLINIC
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-2899
Practice Address - Country:US
Practice Address - Phone:757-314-6312
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024097666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily