| NPI | 1275377970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ELIZABETH WALTER Director Nurse Practitioner 612-710-9176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |