Individual
TAMIKA BRAVEHEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
560 RAY C HUNT DRIVE, CHARLOTTESVILLE, VA 22908-0001
(434) 243-0568
Mailing address
6035 MCCOMB ST, CROZET, VA 22932-3005
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001274056
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/03/2024
Last updated
03/10/2025
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