| NPI | 1265069405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAUDREY STOKES BYRD Administrator 678-523-9046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251E00000X Home Health |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-09-03 |