Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 00241473014 | VA |
NPI | 1013382837 |
---|---|
Provider Name | Mrs. Carrie Shreve Entsminger |
First Address | Richmond, VA 23298-5048 |
Second Address | Midlothian, VA 23113-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2015 |
Last Update Date | 06/02/2016 |