Kevaundra Holloway Tanner
Health & Wellness Coach in Virginia Beach, VA. Individual provider (NPI-1).
NPI number1699648006
StatusActive
Last updated in NPPESSep 24, 2025
Details
- NPI
- 1699648006
- Entity type
- Individual (NPI-1)
- Name
- Kevaundra Holloway Tanner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 24, 2025
- Certification date
- Sep 24, 2025
- Last updated
- Sep 24, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171400000X | Health & Wellness Coach | – | – | Yes |
Practice location
1832 Kempsville Rd Ste 112Virginia Beach, VA 23464-6861
Phone 757-470-4306 · Fax 757-930-6333
Mailing address
5526 Campus DrVirginia Beach, VA 23462-7302
Phone 757-470-4306
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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