| NPI | 1255158788 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA BOMMIE SAUNDERS Credentialing And Billing Rep 910-616-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-09-25 |