| NPI | 1144421462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN GRUBBS CEO 239-878-1294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL arnp9189169) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |