| NPI | 1033717228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ESTHER BAXTER Owner 401-400-5535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-26 |