Provider Demographics
NPI:1154335016
Name:THOUROGOOD, VANESSA TOWNSEND (APRN-BC)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:TOWNSEND
Last Name:THOUROGOOD
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 LONGSTREET AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5838
Mailing Address - Country:US
Mailing Address - Phone:757-422-0277
Mailing Address - Fax:757-422-6843
Practice Address - Street 1:830 SOUTHAMPTON AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1001
Practice Address - Country:US
Practice Address - Phone:757-683-2728
Practice Address - Fax:757-683-8663
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ18082Medicare UPIN
VA004397N38Medicare PIN