Tena, Brandie Jackson

Tena, Brandie Jackson is an individual health care provider with primary practice located at 771 Pilot House Drive , Newport News VA 23606. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Tena, Brandie Jackson can be contacted via phone (757) 873-2123.

Contact Information

Primary practice address
771 Pilot House Drive Newport News VA 23606
Phone: (757) 873-2123
Fax: (757) 873-3848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2305203940 Virginia

Profile Details

NPI number 1396707337
LBN Legal business name Tena, Brandie Jackson
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Feb 4th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396707337 NPPES
Virginia MEDICAID 010105536
Virginia Other 7709582
Virginia Other P00140465

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