Individual
CECILIA OTOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
355 CRAWFORD ST, SUITE 300, PORTSMOUTH, VA 23704-2816
(757) 396-6347
(757) 215-0177
Mailing address
7007 HARBOUR VIEW BLVD, SUITE 108, SUFFOLK, VA 23435-3657
(757) 215-2784
(757) 215-2728
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172429
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05149
MEDICARE GROUP PTAN
VA
Enumeration date
08/19/2015
Last updated
08/19/2015
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