| NPI | 1023634227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAVIS Credentialing Specialist 912-484-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-07-30 |