| NPI | 1023599198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHANELLE HORNE Owner 331-300-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 2083B0002X Preventive Medicine, Obesity Medicine | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2025-05-07 |