Individual
LAURA KATHLEEN CARGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
472 POLARIS ST BLDG 586, VIRGINIA BEACH, VA 23461-1935
(757) 862-0065
Mailing address
472 POLARIS ST BLDG 586, VIRGINIA BEACH, VA 23461-1935
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1096303
NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS
—
Enumeration date
09/12/2011
Last updated
01/19/2023
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