| NPI | 1134558398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME DENNIS Director Revenue Cycle 501-552-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |