Provider Demographics
NPI:1831670181
Name:NIEUWENHUYS, TATIANA G (FNP)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:G
Last Name:NIEUWENHUYS
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 1:301 RIVERVIEW AVE STE 930
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1068
Mailing Address - Country:US
Mailing Address - Phone:757-252-3236
Mailing Address - Fax:
Practice Address - Street 1:301 RIVERVIEW AVE STE 930
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1068
Practice Address - Country:US
Practice Address - Phone:757-252-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN216301363LF0000X
AZAP11769363LF0000X
VA0024188081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ434532Medicaid