| NPI | 1144798943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIE LYNNE POTTER Nurse Practitioner 903-402-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-19 |