Individual
DR. CORLISS VONCILLE BOOKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
14101 LYNDHURST DR, CHESTER, VA 23831-8804
(804) 425-5190
(804) 425-5359
Mailing address
14101 LYNDHURST DR, CHESTER, VA 23831-8804
(804) 425-5190
(804) 425-5359
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
0001085795
VA
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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