| NPI | 1225583743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS LEE NEWBERRY Director/Owner 270-869-8376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 363LA2100X Nurse Practitioner, Acute Care | |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2023-02-22 |