Provider Demographics
NPI:1902584295
Name:PRINCEWILL, NTOH NTOH (SENIOR CARE M)
Entity type:Individual
Prefix:
First Name:NTOH NTOH
Middle Name:
Last Name:PRINCEWILL
Suffix:
Gender:M
Credentials:SENIOR CARE M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W LITTLE CREEK RD STE 104
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-2036
Mailing Address - Country:US
Mailing Address - Phone:757-866-2696
Mailing Address - Fax:
Practice Address - Street 1:801 W LITTLE CREEK RD STE 104
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-2036
Practice Address - Country:US
Practice Address - Phone:757-866-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001307166163WG0000X
VA0002094523164W00000X
VA372600000X, 376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No372600000XNursing Service Related ProvidersAdult Companion
No376K00000XNursing Service Related ProvidersNurse's Aide