| NPI | 1285452375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYMIAN CRISP Practice Manager 336-510-0653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-28 |
| Last Update Date | 2024-10-23 |