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757 Medical Group Lc

Nurse Practitioner, Psych/Mental Health in Newport News, VA. Organization (NPI-2).

NPI number1205468659
StatusActive
Last updated in NPPESApr 18, 2022

Details

NPI
1205468659
Entity type
Organization (NPI-2)
Legal business name
757 Medical Group Lc
Organization subpart
No
Enumeration date
Feb 4, 2020
Certification date
Apr 18, 2022
Last updated
Apr 18, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health––Yes
363LF0000X Nurse Practitioner, Family––

Other names

  • Adhd-Aid (Doing Business As)

Practice location

21 Forrest Dr
Newport News, VA 23606-1901

Phone 757-528-8881 · Fax 757-528-8881

Mailing address

21 Forrest Dr
Newport News, VA 23606-1901

Phone 757-528-8881 · Fax 757-528-8881

Other practice locations

370 Wythe Creek Rd Ste A
Poquoson, VA 23662-1926

Phone 757-528-8881 · Fax 757-528-8881

Authorized official

Brandon Burr
President
7575288881

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