NPI | 1003516113 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE STEGALL Nurse Practitioner/Owner 662-419-9148 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2023-03-07 |
Last Update Date | 2023-03-16 |