| NPI | 1053786483 |
|---|---|
| Doing Business As | UNIVERSITY MEDICAL GROUP/MOBILE HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | KRISTI ANN LAWRENCE Director Provider Enrollment 864-385-4790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2024-04-24 |