| NPI | 1073300828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA DAVIS-BIMEAL Owner 913-850-9048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-10-20 |