| NPI | 1760781447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONTE DANIELLE CHESTNUT Sole Proprietor 804-833-4655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: VA 0002075539) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |