| NPI | 1235813114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY R NEELY Owner / Nurse Practitioner 972-978-2317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-10-17 |