Provider Demographics
NPI:1679996136
Name:PEARSON, DENNIS STEVEN (FNP-BC, NP-C)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:STEVEN
Last Name:PEARSON
Suffix:
Gender:M
Credentials:FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:757-594-4006
Mailing Address - Fax:
Practice Address - Street 1:101 PHILIP ROTH ST
Practice Address - Street 2:SUITE 5A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1393
Practice Address - Country:US
Practice Address - Phone:757-599-6333
Practice Address - Fax:757-591-7261
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171471363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily