| NPI | 1144651431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JENKINS VP 270-827-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LA2100X Nurse Practitioner Acute Care | |
| 363LA2200X Nurse Practitioner Adult Health | |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2020-11-17 |