| NPI | 1225886963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA I ROBISON Office Manager 765-480-8768 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2025-07-31 |