| NPI | 1134570328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE JODY STUBLER Medical Director 385-275-4673 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 2231894405) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-01-09 |