| NPI | 1407455660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAPHNE COOK EDWARDS President/Owner 804-454-1483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2024-09-28 |