| NPI | 1013506567 |
|---|---|
| Other Name | MH HCS AT TYSON NEWBERN |
| Entity Type | Organization |
| Authorized Contact | NANCY CARLSON President 802-857-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2021-01-11 |