Provider Demographics
NPI:1700697901
Name:TAITAGUE SCHOLTEN, JAENA SHEI (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JAENA SHEI
Middle Name:
Last Name:TAITAGUE SCHOLTEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2628
Mailing Address - Country:US
Mailing Address - Phone:804-854-2006
Mailing Address - Fax:
Practice Address - Street 1:895 CITY CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3080
Practice Address - Country:US
Practice Address - Phone:757-599-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110010520363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant