| NPI | 1083135461 |
|---|---|
| Doing Business As | IDEAL PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | SUZANNE CARLISLE STEBENNE Family Nurse Practitioner 202-394-9166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VT 101.0110101) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |