| NPI | 1568218998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA EUBANKS Owner 804-937-4373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 364SA2200X Clinical Nurse Specialist, Adult Health | |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2025-07-05 |