Latrina Blue-Moody
Individual provider Active NPI Driver · Hampton, VA
NPI 1336848704 · NPPES record last updated Feb 27, 2023
Key facts
- NPI
- 1336848704
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 21 Peterborough Dr
Hampton, VA 23666-1464 - Phone
- (757) 503-1352
- NPI assigned
- Feb 24, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | VA | Yes |
Addresses
Primary practice location
21 Peterborough Dr
Hampton, VA 23666-1464
Mailing address
21 Peterborough Dr
Hampton, VA 23666-1464
Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.