| NPI | 1184320236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LECRESHA SEWELL Owner 270-769-5963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health |
| Enumeration Date | 2023-01-31 |
| Last Update Date | 2023-04-21 |