| NPI | 1689177503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUTUM FABRE SIMMONS Owner/Nurse Practitioner 757-330-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175436) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2022-08-24 |