Provider Demographics
NPI:1851325997
Name:STONE, TASHA NIKOLE (NP)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:NIKOLE
Last Name:STONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:NIKOLE
Other - Last Name:GODETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:400 GRESHAM DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1901
Mailing Address - Country:US
Mailing Address - Phone:757-627-6416
Mailing Address - Fax:757-627-3709
Practice Address - Street 1:400 GRESHAM DR
Practice Address - Street 2:SUITE 303
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1901
Practice Address - Country:US
Practice Address - Phone:757-627-6416
Practice Address - Fax:757-627-3709
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily