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General NPI Number Information
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NPI Number | 1477283612
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL CLINIC
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Dates
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Enumeration Date | 06/11/2022
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 101 DOCTORS PARK
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City | GALAX
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State | VA
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Zip | 24333-2277
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Country | US
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Telephone | 276-233-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 101 DOCTORS PARK
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City | GALAX
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State | VA
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Zip | 24333-2277
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Country | US
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Telephone | 276-601-2540
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE KEESLING
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Credential | DNP, AGPCNP-BC
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Telephone | 276-223-2575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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