| NPI | 1245547892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JENKINS VP 270-827-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2023-08-10 |