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 |