Individual
MRS. AMY BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5001 W BROAD ST, RICHMOND, VA 23230-3005
(804) 282-5421
Mailing address
1814 W 45TH ST, RICHMOND, VA 23225-3202
(240) 441-5800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0215451
VA
Other
Enumeration date
02/23/2015
Last updated
04/15/2015
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