NPI | 1003461518 |
---|---|
Entity Type | Organization |
Authorized Contact | MARKIE LYNN VANT HUL A RN P/ Co Owner /Provider 712-470-1498 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
363LF0000X Nurse Practitioner, Family | |
363LP2300X Nurse Practitioner, Primary Care | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2019-08-02 |
Last Update Date | 2019-08-02 |