| NPI | 1194522730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK MITCHELL Owner/CEO 877-969-6863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-03-01 |
| Last Update Date | 2025-03-01 |