NPI | 1144937988 |
---|---|
Entity Type | Organization |
Authorized Contact | STEFANIE PAULUS Practice Manager 844-365-7246 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 207Q00000X Family Medicine |
207QA0505X Family Medicine, Adult Medicine | |
208D00000X General Practice | |
363A00000X Physician Assistant | |
Enumeration Date | 2022-11-01 |
Last Update Date | 2022-11-01 |