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General NPI Number Information
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NPI Number | 1932943081
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Entity Type | Organization
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Legal Business Name | PRETTY LITTLE NURSE LLC
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Dates
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Enumeration Date | 06/24/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 707 GITTINGS ST STE 100B
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City | SUFFOLK
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State | VA
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Zip | 23434-6155
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Country | US
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Telephone | 757-895-1449
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Fax | 757-782-8100
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Provider Business Mailing Address
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Address Line | 5105A SUMMER GARDEN PL
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City | SUFFOLK
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State | VA
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Zip | 23434-8449
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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 | OWNER
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Name | CHANEL CARRINGTON
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Credential |
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Telephone | 757-339-4543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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