| NPI | 1053570788 |
|---|---|
| Former Legal Business Name | WILD ROSE CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEAN A KIMERLING Operation Manager 509-586-6248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: WA AP30002337) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30003677) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |