| NPI | 1548966575 | 
|---|---|
| Doing Business As | OLD DOMINION UNIVERSITY COMMUNITY CARE | 
| Entity Type | Organization | 
| Authorized Contact | TAMMY SPEERHAS Director Of Odu Community Care 757-683-4390  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family | 
| Enumeration Date | 2023-02-01 | 
| Last Update Date | 2023-02-01 |