| NPI | 1134663925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA JOHNSON RN, Ap RN 270-506-2967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2017-03-09 |