| NPI | 1093641102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HERSHBERGER Owner 910-736-7002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2026-06-18 |
| Last Update Date | 2026-07-25 |