| NPI | 1114741949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA K SMOOT Family Nurse Practitioner 804-375-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2025-09-02 |