| NPI | 1023213550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA S GARDNER Owner 228-285-0361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 11452) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2026-02-11 |