| NPI | 1063230019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONTA WALTON Owner 443-600-8178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2024-10-04 |