| NPI | 1023061140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI LYNNE HARMON Provider Specialist Services 336-245-5403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC Student) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-07-24 |