Individual
VENETTA JOI LAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
6551 NE 150TH AVE, WILLISTON, FL 32696-5321
(443) 508-1904
Mailing address
PO BOX 130, ATTN ACL PROVIDER ENROLLMENT, SAN FIDEL, NM 87049-0130
(505) 552-5300
(505) 552-5828
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R121298
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
401222
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
01/15/2008
Last updated
03/24/2021
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