Lively, Jonathan

Lively, Jonathan is an sole proprietor health care provider with primary practice located at 600 Gresham Dr Ste 8630B , Norfolk VA 23507-1904. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lively, Jonathan can be contacted via phone (757) 388-6115.

Contact Information

Primary practice address
600 Gresham Dr Ste 8630B Norfolk VA 23507-1904
Phone: (757) 388-6115
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110002350 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA030452 District of Columbia

Profile Details

NPI number 1285763391
LBN Legal business name Lively, Jonathan
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 5th, 2007
Last updated Sep 29th, 2026 - about 8.1371296296296 days ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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