Most Relevant Information
Provider Data
| NPI Number: | 1003455122 |
| Provider Name: | TONJA MARIE DEVOLGADO NURSE PRACTITIONER |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 0024177680 |
Most Important Dates
| Enumeration Date: | 01/06/2020 |
| Last Updated: | 12/09/2021 |
Provider Practice Location
2075 GLENN MITCHELL DR STE 512
VIRGINIA BEACH
VA
234560179
Practice Location Phone/Fax
| Phone: | 7575078850 |
| Fax: |
Provider Mailing Location
3913 QUARTZ LN
VIRGINIA BEACH
VA
234565860
Provider Mailing Phone/Fax
| Phone: | 7572869864 |
| Fax: |