Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024173873 | VA |
NPI | 1003362799 |
---|---|
Provider Name | Clotilde Jorgina Ramos |
First Address | Virginia Beach, VA 23456-0178 |
Second Address | Virginia Beach, VA 23456-0178 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2016 |
Last Update Date | 01/09/2016 |