| NPI | 1336401058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAN KELSEY Owner 919-829-1315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 136549) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2012-06-08 |