| NPI | 1194693846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEREDESHEE DOCUMENTS FOR HEREDE TAYLOR Nurse Practitioner/ Owner 773-531-9794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-24 |