NPI | 1215396775 |
---|---|
Entity Type | Organization |
Authorized Contact | SHETILA BURRELL Owner/Provider 225-300-6010 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP007758) |
Enumeration Date | 2016-02-12 |
Last Update Date | 2021-01-21 |