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 |