| NPI | 1275119364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD D BASHAM Ap RN/Owner 270-971-1388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2021-04-29 |