| NPI | 1194489260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW C. WALK CEO 833-765-3648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2023-03-13 |