| NPI | 1609612993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAWN WORKMAN Lead Np 434-337-3646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-07-05 |