| NPI | 1083371967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY COOPER Owner/Provider 540-534-9955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-11-26 |
| Last Update Date | 2022-02-11 |