| NPI | 1760433791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE NEVADA JOHNSON Credentialing COO Rdinator 540-536-0103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA H 1916) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA H1916) |
| 1041C0700X Social Worker Clinical (Licence: VA H1916) | |
| 133V00000X Dietitian, Registered (Licence: VA H 1916) | |
| 207P00000X Emergency Medicine (Licence: VA H 1916) | |
| 207RC0000X Internal Medicine Cardiovascular Disease (Licence: VA H1916) | |
| 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: VA H 1916) | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 282N00000X General Acute Care Hospital (Licence: VA H1916) | |
| 363A00000X Physician Assistant (Licence: VA H 1916) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: VA H 1916) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: VA H 1916) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2024-10-16 |