| NPI | 1215575634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM GLOVER Credentialing Managing / Member 202-459-1568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251S00000X | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2023-10-29 |