NPI | 1033861349 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL BAKER President 857-255-0486 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 207R00000X Internal Medicine |
207Q00000X Family Medicine | |
363LA2100X Nurse Practitioner, Acute Care | |
363LA2200X Nurse Practitioner, Adult Health | |
363LF0000X Nurse Practitioner, Family | |
363LG0600X Nurse Practitioner, Gerontology | |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2022-01-19 |
Last Update Date | 2024-01-21 |