| NPI | 1023899309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN N KIERNAN Np 870-403-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2024-07-31 |