| NPI | 1205597721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI LISA D CAMPBELL Owner/Provider 910-613-7441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-10-04 |