| NPI | 1295359883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMEKA SHAVONNE HATHAWAY Family Nurse Practitioner 757-513-9282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2020-05-30 |