| NPI | 1295391480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2024-08-15 |