| NPI | 1184890535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOLA FAYE HOUSTON Gerontological Nurse Practitioner 270-929-9971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: KY ARNP 2129P) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |