| NPI | 1164887873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DANIEL HANCOCK Owner 910-491-4530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 201679) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2025-11-05 |