| NPI | 1245780303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL LYNN KEELER Hr Manager 910-929-6944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 900257) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2022-07-20 |