| NPI | 1134723794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARLETTE OWENS-MOSLEY Provider 980-207-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2025-06-05 |