Provider Demographics
NPI:1881333045
Name:PINK, NADINE ANTOINETTE (RN)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:ANTOINETTE
Last Name:PINK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8050 RUTLAND VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2971
Mailing Address - Country:US
Mailing Address - Phone:757-806-8382
Mailing Address - Fax:
Practice Address - Street 1:8050 RUTLAND VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2971
Practice Address - Country:US
Practice Address - Phone:757-806-8382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001161044163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse