| NPI | 1003843376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL LADD ANDERSON Vaccine Coordinator 919-542-5673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NC 166286) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2022-07-21 |