| NPI | 1508286725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L FELLMAN Owner 757-348-4736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166865) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2014-04-27 |