| NPI | 1356695613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JANE RANDELL Billing Manager 252-728-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 900119) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-12-19 |