NPI | 1205870862 |
---|---|
Entity Type | Organization |
Authorized Contact | DENEACE CLEMONS COO 270-259-1626 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
207X00000X Orthopaedic Surgery | |
207Y00000X Otolaryngology | |
207QS0010X Family Medicine, Sports Medicine | |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
2084N0400X Psychiatry & Neurology, Neurology | |
208600000X Surgery | |
207Q00000X Family Medicine | |
208D00000X General Practice | |
231H00000X Audiologist | |
363LA2200X Nurse Practitioner, Adult Health | |
363LF0000X Nurse Practitioner, Family | |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2006-06-15 |
Last Update Date | 2019-12-09 |