| NPI | 1326938713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SKYLAR MATTINGLY Ap RN/Owner 270-216-8896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-07-07 |
| Last Update Date | 2025-08-12 |