| NPI | 1164156188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYSHA M JONES Owner 443-836-5793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-07-09 |