Provider Demographics
NPI:1952357261
Name:HAKALA, NANCY H (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:H
Last Name:HAKALA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:GOOCHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23063-0189
Mailing Address - Country:US
Mailing Address - Phone:804-556-5400
Mailing Address - Fax:804-556-5403
Practice Address - Street 1:3910 OLD BUCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5719
Practice Address - Country:US
Practice Address - Phone:804-598-2200
Practice Address - Fax:804-598-3114
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050008852251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA106314OtherANTHEM
VA10863OtherVALUE OPTIONS
VA44157OtherSENTARA
VA106314OtherHEALTHKEEPERS
VA244011OtherMAMSI