| NPI | 1255272035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN NEWBERRY Authorized Official 385-454-5027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2026-04-03 |
| Last Update Date | 2026-04-03 |