| NPI | 1295122521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MULLLISSA CHILDRESS CEO 614-496-8420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 16446-NP) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2022-07-21 |