MEDICARE: DESIREE RAQUEL OUTLAW NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	337212	NY
2	363LF0000X	Family Nurse Practitioner	1292471	VA
3	363LF0000X	Family Nurse Practitioner	0024178891	VA

General Provider Information

NPI Number	:	1790051910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DESIREE RAQUEL OUTLAW NP

Provider Business Mailing Address
First Line	:	1328 E PEMBROKE AVE
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-2445
Country	:	US
Telephone Number	:	757-379-1660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1328 E PEMBROKE AVE
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23669-2445
Country	:	US
Telephone Number	:	757-379-1660
Fax Number	:	855-679-9729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2012
Last Update Date	:	10/17/2024

Similar Medicare Providers

1477067288 — WINTER LAUREN SEWARD-DIXON FNP-C
Practice Location Address:

1328 E PEMBROKE AVE
HAMPTON, VA
23669-2445

Practice Phone: 757-904-3319
Practice Fax:

1023602026 — DESIRABLE HEALTHCARE, LLC
Practice Location Address:

1328 E PEMBROKE AVE
HAMPTON, VA
23669-2445

Practice Phone: 757-379-1660
Practice Fax: 855-679-9729

1164017752 — HAMPTON ROADS WELLNESS CENTER LLC
Practice Location Address:

1328 E PEMBROKE AVE
HAMPTON, VA
23669-2445

Practice Phone: 757-904-3319
Practice Fax: 833-301-0790

1285732032 — JOHN (JACK) JOSEPH COLLINS LCMHC
Practice Location Address:

216 LAFAYETTE RD , #206
NORTH HAMPTON, NH
03862-2445

Practice Phone: 603-964-1700
Practice Fax: 603-964-1701

1093894313 — DR. BARTLOMIEJ M RZEPA D.C.
Practice Location Address:

216 LAFAYETTE RD
NORTH HAMPTON, NH
03862-2445

Practice Phone: 603-964-1103
Practice Fax: 603-964-8074

1992850754 — CROSSROADS COUNSELING CENTER, PLLC
Practice Location Address:

216 LAFAYETTE RD , SUITE 206
NORTH HAMPTON, NH
03862-2445

Practice Phone: 603-964-1700
Practice Fax: 603-964-1701

Directions to “ DESIREE RAQUEL OUTLAW NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.