| NPI | 1215491311 |
|---|---|
| Doing Business As | METHODIST FAMILY MEDICINE KLUTEY PARK |
| Entity Type | Organization |
| Authorized Contact | BENNY NOLEN President And CEO 270-827-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-07-23 |