| NPI | 1124719596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH DAVIS Owner 667-367-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2025-02-18 |