| NPI | 1134713159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEISTEY TINDALL Owner 704-476-9144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2022-04-29 |