| NPI | 1336879097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA JOHNSON Mgr 904-497-2192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-05-23 |