Provider Demographics
NPI:1407593726
Name:SUPERIOR HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:SUPERIOR HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEREKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:757-912-4351
Mailing Address - Street 1:11847 CANON BLVD STE 11B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4579
Mailing Address - Country:US
Mailing Address - Phone:757-697-9288
Mailing Address - Fax:959-777-3873
Practice Address - Street 1:11847 CANON BLVD STE 11B
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4579
Practice Address - Country:US
Practice Address - Phone:757-697-9288
Practice Address - Fax:959-777-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty