Provider Demographics
NPI:1396781803
Name:SAMUEL, NAVEEN HALIM (ANP, FNP)
Entity type:Individual
Prefix:MRS
First Name:NAVEEN
Middle Name:HALIM
Last Name:SAMUEL
Suffix:
Gender:F
Credentials:ANP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7605 FOREST AVE
Mailing Address - Street 2:PROFESSIONAL OFFICE BUILDING SUITE 303
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4938
Mailing Address - Country:US
Mailing Address - Phone:804-289-4941
Mailing Address - Fax:804-289-4707
Practice Address - Street 1:7605 FOREST AVE
Practice Address - Street 2:PROFESSIONAL OFFICE BUILDING SUITE 303
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4938
Practice Address - Country:US
Practice Address - Phone:804-289-4941
Practice Address - Fax:804-289-4707
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165882363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health