| NPI | 1417608852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTAL OUTLAW Owner 757-748-4643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WC1600X Registered Nurse, Continuing Education/Staff Development |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 305S00000X Point of Service | |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2023-01-25 |