| NPI | 1205376480 |
|---|---|
| Doing Business As | ASCENSION MEDICAL GROUP SACRED HEART |
| Doing Business As | SHMG WALGREENS 9TH |
| Entity Type | Organization |
| Authorized Contact | MIRANDA HEMM Enrollment Manager 904-450-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2021-05-12 |