| NPI | 1255933305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JENKINS VP 270-827-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine Pulmonary Disease |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner Acute Care | |
| Enumeration Date | 2020-11-13 |
| Last Update Date | 2024-02-27 |