Provider Demographics
NPI:1760135172
Name:FERNANDES, ZENIA
Entity Type:Individual
Prefix:
First Name:ZENIA
Middle Name:
Last Name:FERNANDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4349 INDIAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3115
Mailing Address - Country:US
Mailing Address - Phone:757-414-9163
Mailing Address - Fax:757-530-4326
Practice Address - Street 1:4349 INDIAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3115
Practice Address - Country:US
Practice Address - Phone:757-414-9163
Practice Address - Fax:757-530-4326
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-222709251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health