| NPI | 1215476304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIETTA MILLER Administrator 867-388-1577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN209845) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |