| NPI | 1164174355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA SHUMWAY Owner 606-371-9945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-06-27 |