| NPI | 1033972047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATARA TAYLOR Pmhnp, Fnp Bc 904-200-8978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |