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 |