Provider Demographics
NPI:1710375274
Name:TOLEDO, CARLA (RN, MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:
Last Name:TOLEDO
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Gender:F
Credentials:RN, MSN, FNP-C
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Mailing Address - Street 1:7007 HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3657
Mailing Address - Country:US
Mailing Address - Phone:757-215-2784
Mailing Address - Fax:757-215-2728
Practice Address - Street 1:155 KINGSLEY LANE
Practice Address - Street 2:SUITE 400
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505
Practice Address - Country:US
Practice Address - Phone:757-889-4280
Practice Address - Fax:757-889-4285
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-05-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024172244363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06209Medicare PIN