| NPI | 1346071586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CHRISTINE RENFRO Cnp CFO/Cmo 817-897-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2025-01-07 |