| NPI | 1346021482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTZ BURY Owner 757-585-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2025-03-14 |