| NPI | 1306734330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACKENZIE MCMINN Sole Member 772-267-7954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2025-06-26 |
| Last Update Date | 2025-06-26 |