| NPI | 1164701447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER GREEN Business Manager 270-748-6851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2016-05-24 |