Basic Information
Provider Information
NPI: 1780972349
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALDERSON
FirstName: DANA
MiddleName: HAGUE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 91734
Address2:  
City: RICHMOND
State: VA
PostalCode: 232911734
CountryCode: US
TelephoneNumber: 8043586100
FaxNumber: 8043427619
Practice Location
Address1: 9000 STONY POINT PKWY
Address2:  
City: RICHMOND
State: VA
PostalCode: 23235
CountryCode: US
TelephoneNumber: 8045608921
FaxNumber: 8045608992
Other Information
ProviderEnumerationDate: 07/18/2011
LastUpdateDate: 05/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X0017141743VAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X0024171941VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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