Provider Demographics
NPI:1508222563
Name:EARLY, JEMILA DANIELLE (CSFA, LSA)
Entity type:Individual
Prefix:
First Name:JEMILA
Middle Name:DANIELLE
Last Name:EARLY
Suffix:
Gender:
Credentials:CSFA, LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 CONSTITUTION DRIVE
Mailing Address - Street 2:ONE COLUMBUS CENTER, SUITE 600
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-206-4325
Mailing Address - Fax:
Practice Address - Street 1:283 CONSTITUTION DRIVE
Practice Address - Street 2:ONE COLUMBUS CENTER, SUITE 600
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-206-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant