Provider Demographics
NPI:1053781005
Name:TROTTER, TENIKA
Entity type:Individual
Prefix:
First Name:TENIKA
Middle Name:
Last Name:TROTTER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W WASHINGTON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5320
Mailing Address - Country:US
Mailing Address - Phone:757-644-0208
Mailing Address - Fax:
Practice Address - Street 1:425 W WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5320
Practice Address - Country:US
Practice Address - Phone:757-644-0208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001236457163WH0200X
VA0024192271363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health