| NPI | 1295627834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKIA MIXON Owner / Nurse Practitioner (Fnp C) 980-699-5320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2026-04-16 |