NPI 1205484441 · live from the CMS NPI Registry
Advance Practice Geriatrics And Wound Specialist, LLC
Nurse Practitioner, Gerontology in Rural Retreat, VA. National Provider Identifier 1205484441, active.
NPI record
| NPI | 1205484441 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Gerontology 363LG0600X |
| Practice location | 514 N Main St, Rural Retreat, VA 24368 |
| Practice phone | 276-783-1827 |
| Mailing address | 1048 Terrace Dr, Marion, VA 24354 |
| Enumerated | August 30, 2019 |
| Last updated | September 9, 2019 |
| Authorized official | Nancy Marshall, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Gerontology primary | 363LG0600X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.