Provider Demographics
NPI:1457171928
Name:GILLESPIE, UHURUA AMBER-FAWNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:UHURUA
Middle Name:AMBER-FAWNN
Last Name:GILLESPIE
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HUSTINGS LANE
Mailing Address - Street 2:UNIT D
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608
Mailing Address - Country:US
Mailing Address - Phone:757-814-9923
Mailing Address - Fax:
Practice Address - Street 1:3235 ACADEMY AVE STE 305
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3200
Practice Address - Country:US
Practice Address - Phone:757-686-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024191301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily