| NPI | 1366231151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY ANNETTE FLUKER Owner/Authorized Official 904-305-9512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |