Provider Demographics
NPI:1457142002
Name:TOTTEN, AMANDA NADINE SHEILA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:NADINE SHEILA
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1734
Mailing Address - Country:US
Mailing Address - Phone:757-706-1996
Mailing Address - Fax:
Practice Address - Street 1:10510 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3102
Practice Address - Country:US
Practice Address - Phone:757-594-4720
Practice Address - Fax:757-594-4720
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024193878363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty