Provider Demographics
NPI:1356810436
Name:CEBRELLI, ANN-MARIE VASANTI (PA)
Entity type:Individual
Prefix:
First Name:ANN-MARIE
Middle Name:VASANTI
Last Name:CEBRELLI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:CEBRELLI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1020 FIRST COLONIAL RD STE A
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3078
Mailing Address - Country:US
Mailing Address - Phone:757-395-1850
Mailing Address - Fax:
Practice Address - Street 1:1020 FIRST COLONIAL RD STE A
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3078
Practice Address - Country:US
Practice Address - Phone:757-395-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110006136363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant