| NPI | 1275269573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE SEIDLE Owner 904-619-6227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |