| NPI | 1093000283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL A WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207R00000X Internal Medicine | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2017-08-10 |