| NPI | 1164769675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH TEUSCHER BEARDSLEY President 386-365-2046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-01-04 |