Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 0024182094 | VA |
NPI | 1063083053 |
---|---|
Provider Name | Mrs. Annette Dean |
First Address | Chesterfield, VA 23838-6256 |
Second Address | Richmond, VA 23235-1979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2021 |
Last Update Date | 09/07/2021 |