Individual
BETTY TEMPLES MILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
51 WILLIAM B GRAHAM CT, KILMARNOCK, VA 22482-3852
(804) 435-0575
(804) 435-9017
Mailing address
PO BOX 1694, KILMARNOCK, VA 22482-1694
(804) 435-0575
(804) 435-9017
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0024110321
VA
363LP2300X
Primary Care Nurse Practitioner
0024110321
VA
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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