Provider Demographics
NPI:1760631667
Name:SILVA, STEPHANIE M (CNM, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:M
Last Name:SILVA
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:M
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP, CNM
Mailing Address - Street 1:3281 BARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-7904
Mailing Address - Country:US
Mailing Address - Phone:617-877-5543
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR STE 106
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:579-534-3767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR223337363LW0102X, 367A00000X
MA278031363LW0102X
VA0024176734367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22580Other22580