| NPI | 1720298086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN R SMITH Owner 757-340-3489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024069582) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-10-05 |