Andria Nanette Wallen, | |
500 Discovery Dr, Chesapeake, VA 23320-3871 | |
(757) 668-2500 | |
Not Available |
Full Name | Andria Nanette Wallen |
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Gender | Female |
Speciality | Pediatrics |
Location | 500 Discovery Dr, Chesapeake, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326400326 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 0102205560 (Virginia) | Primary |
Entity Name | Childrens Specialty Group Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255354130 PECOS PAC ID: 5890788764 Enrollment ID: O20040406001195 |
Mailing Address | Practice Location Address |
---|---|
Andria Nanette Wallen, 601 Childrens Ln, Norfolk, VA 23507-1910 Ph: (757) 668-7272 | Andria Nanette Wallen, 500 Discovery Dr, Chesapeake, VA 23320-3871 Ph: (757) 668-2500 |
Thedia J Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 733 Volvo Pkwy, Suite 200, Chesapeake, VA 23320 Phone: 757-547-5851 Fax: 888-371-4920 | |
Dr. Michelle Davis Eichelberger, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 Discovery Dr, Suite 302, Chesapeake, VA 23320 Phone: 757-668-2500 Fax: 757-668-2510 | |
Mrs. Rachel Ann Mcclanahan, CPNP-PC Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 656 Independence Pkwy, Chesapeake, VA 23320 Phone: 757-410-3630 | |
Zaharoula Viennas, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 817 Volvo Pkwy, Chesapeake, VA 23320 Phone: 757-668-4630 | |
Dr. Luis F. Olmedo, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 817 Volvo Pkwy, Chesapeake, VA 23320 Phone: 757-668-4630 | |
Takara S Jobe, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 500 Discovery Dr, Suite 302, Chesapeake, VA 23320 Phone: 757-668-2500 Fax: 757-668-2510 | |
Dionne N Harewood, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 4012 Raintree Rd, Suite 200a, Chesapeake, VA 23321 Phone: 757-488-2223 Fax: 757-488-8398 |