| NPI | 1013066950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS KERSEY Director 1866-935-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN070078) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |