| NPI | 1790665164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA PARKER Nurse Practitioner 757-546-4494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-05 |
| Last Update Date | 2026-09-11 |