| NPI | 1083230312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI L HOLMES Credentialing Specialist 386-882-8736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse Registered Nurse First Assistant |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |