| NPI | 1548922461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEREKA JENKINS Administrator 757-697-9288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-10-07 |
| Last Update Date | 2021-10-07 |