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General NPI Number Information
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NPI Number | 1760116156
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Entity Type | Organization
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Legal Business Name | ONE BODY FAMILY PRACTICE
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 2533 COWAN BLVD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-8440
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Country | US
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Telephone | 540-903-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 2533 COWAN BLVD
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-8440
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | CRYSTAL MILLER-WILLIAMS
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Credential | NP
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Telephone | 540-903-4750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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