| NPI | 1629519111 |
|---|---|
| Former Legal Business Name | FAN FREE CLINIC |
| Entity Type | Organization |
| Authorized Contact | KAREN LEGATO Executive Director 804-716-5830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 133N00000X Nutritionist | |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 163W00000X Registered Nurse | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 163WC0400X Registered Nurse, Case Management | |
| 163WC1500X Registered Nurse, Community Health | |
| 207QA0505X Family Medicine, Adult Medicine | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2022-02-09 |