| NPI | 1316775091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRICE MARTIN Owner 402-884-9059 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-08-10 |