| NPI | 1063823888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON A CAMPBELL CEO 1347-915-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 336193) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2015-09-18 |