Provider Demographics
NPI:1821564154
Name:ADAMS, TAJA MASHAY (FNP)
Entity Type:Individual
Prefix:
First Name:TAJA
Middle Name:MASHAY
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TAJA
Other - Middle Name:M
Other - Last Name:DYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:224 CASTLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-3530
Mailing Address - Country:US
Mailing Address - Phone:423-834-0212
Mailing Address - Fax:
Practice Address - Street 1:6161 KEMPSVILLE CIR STE 315
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3935
Practice Address - Country:US
Practice Address - Phone:757-461-5400
Practice Address - Fax:757-461-3305
Is Sole Proprietor?:No
Enumeration Date:2018-10-14
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024176751363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care