Provider Demographics
NPI:1063171650
Name:NDIPISIRI, ADELINE MAGHA (FNP)
Entity type:Individual
Prefix:MS
First Name:ADELINE
Middle Name:MAGHA
Last Name:NDIPISIRI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4243 WHITE CAP CRST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3256
Mailing Address - Country:US
Mailing Address - Phone:757-401-8424
Mailing Address - Fax:
Practice Address - Street 1:4243 WHITE CAP CRST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3256
Practice Address - Country:US
Practice Address - Phone:757-401-8424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily