Provider Demographics
NPI:1851434294
Name:DOWELL, NELDARA ANN (NP)
Entity Type:Individual
Prefix:
First Name:NELDARA
Middle Name:ANN
Last Name:DOWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 KINGSLEY LN
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4604
Mailing Address - Country:US
Mailing Address - Phone:757-451-0929
Mailing Address - Fax:757-434-8953
Practice Address - Street 1:100 KINGSLEY LN
Practice Address - Street 2:SUITE 400
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4604
Practice Address - Country:US
Practice Address - Phone:757-451-0929
Practice Address - Fax:757-434-8953
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024070037367A00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007790465Medicaid