NPI | 1063855450 |
---|---|
Entity Type | Organization |
Authorized Contact | LEA NUNES-VAIS Cms 502-292-8973 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
2080P0216X Pediatrics, Pediatric Rheumatology | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner, Family | |
363LP0200X Nurse Practitioner, Pediatrics | |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2013-04-16 |
Last Update Date | 2023-06-28 |