| NPI | 1043354319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULETTE ANGELA KIRBY Owner 605-484-9775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SD 0330) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2021-12-01 |