| NPI | 1124797733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISHIA FEATHERSTON Owner 682-253-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2024-09-19 |