| NPI | 1003378738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRIET EYVONNE CADLE Owner 678-903-5143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2021-05-11 |