| NPI | 1356129274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ADOLPH NIEMANN Nurse Practitioner 931-801-1484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-11-29 |