| NPI | 1023602026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIREE OUTLAW Owner 757-379-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2023-10-30 |