| NPI | 1104226471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY DIANE COOKUS Cpnp/Advanced Practice Nurse 501-515-8877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: AR A004159) |
| Enumeration Date | 2014-08-24 |
| Last Update Date | 2014-08-24 |